MEDICARE: DR. GIOVANNI CASTRO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	13265	NC
2	1223G0001X	General Practice Dentistry	13265	NC

General Provider Information

NPI Number	:	1467198028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GIOVANNI CASTRO DMD

Provider Business Mailing Address
First Line	:	PO BOX 640
Second Line	:
City	:	ROANOKE RAPIDS
State	:	NC
Zip	:	27870-0640
Country	:	US
Telephone Number	:	252-536-5844
Fax Number	:	252-519-0154

Provider Business Practice Location Address
First Line	:	9409 NC HIGHWAY 305
Second Line	:
City	:	JACKSON
State	:	NC
Zip	:	27845-9679
Country	:	US
Telephone Number	:	252-536-5920
Fax Number	:	252-519-0154

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/06/2022
Last Update Date	:	04/11/2025

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