MRS. JORDAN ANTONISSE CASTILLO D.D.S. NPI 1104208172

NPI Information

  • NPI: 1104208172
  • Provider Name: MRS. JORDAN ANTONISSE CASTILLO, D.D.S.
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 8200 DODGE ST
    OMAHA, NE
    ZIP 68114
  • Phone: (402) 552-7267

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NPI Details

MRS. Jordan Antonisse Castillo, D.D.S. is a general practice dentist in Omaha, NE. The provider is 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. MRS. Jordan Antonisse Castillo, D.D.S. NPI is 1104208172. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

8200 DODGE ST
OMAHA, NE
ZIP 68114-113
Phone: (402) 552-7267

The enumeration date for this NPI number is 6/25/2015 and was last updated on 7/21/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice2017000011MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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