Healthcare Provider Details

I. General information

NPI: 1679259642
Provider Name (Legal Business Name): GUILLERMO CHRISTIAN CASTRO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2023
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

86-260 FARRINGTON HIGHWAY
WAIANAE HI
96792-0241
US

IV. Provider business mailing address

86-260 FARRINGTON HIGHWAY
WAIANAE HI
96792
US

V. Phone/Fax

Practice location:
  • Phone: 808-697-3300
  • Fax: 808-697-3687
Mailing address:
  • Phone: 808-697-3300
  • Fax: 808-697-3687

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDN123780
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: