Individual provider Active NPI

Joseph Vincent Califano, DDS, PHD

  • Periodontics
  • Portland, OR
National Provider Identifier
1053533745
Registry record updated Jun 8, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
D10187 Issued in OR
Practice address
2730 SW Moody Ave
Mail Code SD-Peri
Portland, OR 97201-5042
Phone
(503) 346-4772
Fax
(503) 494-8351
NPI assigned
May 3, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X D10187 OR Primary

Addresses

Primary practice location

2730 SW Moody Ave
Mail Code SD-Peri
Portland, OR 97201-5042

Mailing address

2730 SW Moody Ave
Mail Code SD-Peri
Portland, OR 97201-5042
Phone (503) 346-4772

Other identifiers 1

IdentifierTypeStateIssuer
1053533745OtherNPI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260302002459 NC Practitioner - Dentist 0749762540 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
Virginia Commonwealth Univ School of Dentistry, 1984
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1851 Macgregor Downs Rd
Greenville, NC 27834-5925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
D10187ORMDPeriodontist
9252NCMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Carolina University CurrentSince Mar 16, 2026 Accepting new patients
East Carolina University CurrentSince Mar 16, 2026 Accepting new patients

Locations

1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1433721600000",
    "number": "1053533745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVE",
            "address_2": "MAIL CODE SD-PERI",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-346-4772",
            "fax_number": "503-494-8351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 SW MOODY AVE",
            "address_2": "MAIL CODE SD-PERI",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972015042",
            "telephone_number": "503-346-4772",
            "fax_number": "503-494-8351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIFANO",
        "first_name": "JOSEPH",
        "middle_name": "VINCENT",
        "credential": "DDS, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2015-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D10187",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1053533745",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

Verify at the official NPI Registry.