Healthcare Provider Details

I. General information

NPI: 1831866979
Provider Name (Legal Business Name): PAOLA SASHELL GOMEZ CASTRO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2021
Last Update Date: 04/11/2026
Certification Date: 04/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22733 ALLEN RD
WOODHAVEN MI
48183-2245
US

IV. Provider business mailing address

2700 MARTIN LUTHER KING JR BLVD
DETROIT MI
48208-2576
US

V. Phone/Fax

Practice location:
  • Phone: 734-752-6045
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901602928
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: