Peter Orlando Calderon, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

3023080 Issued in OH

Practice address

6658 Airport Hwy
Holland, OH 43528-8135

Phone

(419) 867-3400

NPI assigned

Jul 24, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Calderon Dental Group LLC

  • General Practice Dentistry
  • Holland, OH
  • NPI 1336667062
  NPD (past) Authorized official
• Calderon Dental Inc

  • General Practice Dentistry
  • Holland, OH
  • NPI 1790061109
  NPD (past) Authorized official
• Henry Ford Health Macomb-Oakland Hospital

  • Social Worker
  • Warren, MI
  • NPI 1548609761
  NPD (past)

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

{
    "created_epoch": "1216857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655510400000",
    "number": "1053576587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6658 AIRPORT HWY",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288135",
            "telephone_number": "419-867-3400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6658 AIRPORT HWY",
            "city": "HOLLAND",
            "state": "OH",
            "postal_code": "435288135",
            "telephone_number": "419-867-3400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "PETER",
        "middle_name": "ORLANDO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-24",
        "last_updated": "2022-06-18",
        "certification_date": "2022-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019906",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "3023080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bue, DDS
• Latoyia Woodson Burgess
• Sonja Elizabeth Calbert
• Calderon Dental Group LLC
• Calderon Dental Inc
• Capital Eyes LLC
• Cardinal Health 414, LLC
• Caring for Yours LLC
• Adrian Bradley Carlson
• Abby Kathleen Carrizales

• Dentist in Holland, OH
• Providers in Holland, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.