Provider Demographics
NPI:1720302516
Name:OSCAR CASTANEDA, D.D.S., M.S., P.A.
Entity Type:Organization
Organization Name:OSCAR CASTANEDA, D.D.S., M.S., P.A.
Other - Org Name:OSCAR CASTANEDA, D.D.S., M.S., P.A.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:OSCAR
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-398-4369
Mailing Address - Street 1:21434 PROVINCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77450-7587
Mailing Address - Country:US
Mailing Address - Phone:281-398-4369
Mailing Address - Fax:281-398-4328
Practice Address - Street 1:21434 PROVINCIAL BLVD
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77450-7587
Practice Address - Country:US
Practice Address - Phone:281-398-4369
Practice Address - Fax:281-398-4328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-23
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19890122300000X, 1223P0700X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX809D10Medicare UPIN
TX00564HMedicare PIN