Healthcare Provider Details

I. General information

NPI: 1326887456
Provider Name (Legal Business Name): YASMEEN SIRIPATHANE CASTRO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2024
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3710 13TH AVE
BROOKLYN NY
11218-3602
US

IV. Provider business mailing address

3710 13TH AVE
BROOKLYN NY
11218-3602
US

V. Phone/Fax

Practice location:
  • Phone: 718-686-7600
  • Fax:
Mailing address:
  • Phone: 718-686-7600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number064589
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: