MEDICARE: DR. ARTURO CASTELLANOS D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	60888	CA

General Provider Information

NPI Number	:	1598041865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ARTURO CASTELLANOS D.D.S.

Provider Business Mailing Address
First Line	:	19206 MAYALL ST
Second Line	:
City	:	NORTHRIDGE
State	:	CA
Zip	:	91324-1256
Country	:	US
Telephone Number	:	818-599-1908
Fax Number	:

Provider Business Practice Location Address
First Line	:	5631 LANKERSHIM BLVD
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91601-1723
Country	:	US
Telephone Number	:	818-505-0067
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2011
Last Update Date	:	10/31/2011

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