Healthcare Provider Details

I. General information

NPI: 1134055445
Provider Name (Legal Business Name): LUIS CARLOS CASTILLO DH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

360 W 13TH AVE UNIT 918
DENVER CO
80204-2734
US

IV. Provider business mailing address

360 W 13TH AVE UNIT 918
DENVER CO
80204-2734
US

V. Phone/Fax

Practice location:
  • Phone: 713-261-5467
  • Fax:
Mailing address:
  • Phone: 303-296-4873
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberDH002027360
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: