Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1104208172 Individual Practitioner Female Practitioner

Dr. Jordan Antonisse Castillo , DDS

Dentist - General Practice • Omaha, NE

Professional Overview & Biography Verified Profile Summary

Dr. Jordan Castillo, DDS is a registered healthcare professional specializing in Dentist - General Practice in Omaha, NE. Practice services are available at 8200 DODGE ST under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8200 Dodge St

Omaha, NE 681144113

Telephone 4025527267
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Omaha, NE

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 13.8 Yrs
State Avg: 19.2 Yrs
Regional Practice Density
282 Specialists

Practicing in Omaha, NE (832 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2020-04-30
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MO 2017000011

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1174044689

Doctor of Dental Surgery

Tama Trewet , RDH

Dental Hygienist

NPI 1699173419

Registered Dental Hygienist

NPI 1821584566

Doctor of Dental Surgery

NPI 1881510378

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

15 Historical Events
📍
Updated Practice Location April 30, 2020

Registered at 8200 DODGE ST, OMAHA, NE 681144113 (Tel: 4025527267)

📍
Updated Business Mailing Address April 30, 2020

Registered at 4508 NE 85TH ST, KANSAS CITY, MO 641567802 (Tel: 2145351488)

👤
Provider Name / Credentials Updated April 30, 2020

Recorded as JORDAN CASTILLO, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 30, 2020

Dentist (License #2017000011 in MO)

NPI Profile Active January 29, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location January 29, 2018

Registered at 6340 N CHATHAM AVE, KANSAS CITY, MO 64151 (Tel: 8167461171)

📍
Updated Business Mailing Address January 29, 2018

Registered at 2555 HOLMES ST, KANSAS CITY, MO 64108 (Tel: 2145351488)

👤
Provider Name / Credentials Updated January 29, 2018

Recorded as JORDAN ANTONISSE, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 29, 2018

Dentist (License #31004 in TX)

NPI Profile Active June 25, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location June 25, 2015

Registered at 5110 MAIN ST, STE #300, FRISCO, TX 750332968 (Tel: 9723775990)

📍
Updated Business Mailing Address June 25, 2015

Registered at 5110 MAIN ST, STE #300, FRISCO, TX 750332968 (Tel: 9723775990)

👤
Provider Name / Credentials Updated June 25, 2015

Recorded as JORDAN ANTONISSE, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 25, 2015

Dentist (License #31004 in TX)

🟢
Initial NPI Registration & Enumeration June 25, 2015

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1104208172
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 25, 2015
Last Update: July 21, 2022
Sole Proprietor: Yes

Mailing Address

4508 Ne 85th St

Kansas City, MO 641567802

Phone: 2145351488

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.