Healthcare Provider Details

I. General information

NPI: 1508774746
Provider Name (Legal Business Name): CASTELLARI SMILE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2026
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17970 SIERRA HWY
CANYON COUNTRY CA
91351-3023
US

IV. Provider business mailing address

17970 SIERRA HWY
CANYON COUNTRY CA
91351-3023
US

V. Phone/Fax

Practice location:
  • Phone: 213-846-2607
  • Fax:
Mailing address:
  • Phone: 213-846-2607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: ROCIO CASTELLARI
Title or Position: OWNER
Credential:
Phone: 213-846-2607