Provider Demographics
NPI:1437274719
Name:SEBASTIAN J. CASTELLANO, DDS, PA
Entity type:Organization
Organization Name:SEBASTIAN J. CASTELLANO, DDS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SEBASTIAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:CASTELLANO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:813-878-0300
Mailing Address - Street 1:302 S MACDILL AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33609-3142
Mailing Address - Country:US
Mailing Address - Phone:813-878-0300
Mailing Address - Fax:813-878-0301
Practice Address - Street 1:302 S MACDILL AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-3142
Practice Address - Country:US
Practice Address - Phone:813-878-0300
Practice Address - Fax:813-878-0301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL125871223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty