Provider Demographics
NPI:1881722197
Name:CASTRO, JAIME TOMAS (DMD)
Entity type:Individual
Prefix:DR
First Name:JAIME
Middle Name:TOMAS
Last Name:CASTRO
Suffix:
Gender:
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PASEO MAYOR
Mailing Address - Street 2:C29 CALLE 8
Mailing Address - City:SAN JUAN
Mailing Address - State:PR
Mailing Address - Zip Code:00926-4671
Mailing Address - Country:US
Mailing Address - Phone:787-800-3333
Mailing Address - Fax:
Practice Address - Street 1:URB. SANTA CRUZ, 1 ST STREET
Practice Address - Street 2:D9
Practice Address - City:BAYAMON
Practice Address - State:PR
Practice Address - Zip Code:00961
Practice Address - Country:US
Practice Address - Phone:787-779-7171
Practice Address - Fax:787-785-6800
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PR23101223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PR42426OtherSSS
PR9690075OtherHUMANA
PRA633OtherIMC FIRST MEDICAL
PRA633OtherIMC FIRST MEDICAL
PR9690075OtherHUMANA