Individual provider Active NPI

Joseph V Calderone Jr., D.M.D.

  • Dentist
  • Debary, FL
National Provider Identifier
1083869457
Registry record updated Nov 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9410 Issued in FL
Practice address
415 Summerhaven Dr
Debary, FL 32713-2716
Phone
(386) 668-8600
Fax
(386) 668-0031
NPI assigned
Nov 26, 2008
Last updated
Nov 26, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9410 FL Primary

Addresses

Primary practice location

415 Summerhaven Dr
Debary, FL 32713-2716

Mailing address

415 Summerhaven Dr
Debary, FL 32713-2716
Phone (386) 668-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20150709003006 FL Order and Referring Only - DentistPractitioner - Dentist 5799097341

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9410FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Joseph V Calderone Jr DMD PA Dentist Past Accepting new patients

Networks

  • Freedom Health HMO Network

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1083869457",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 SUMMERHAVEN DR",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132716",
            "telephone_number": "386-668-8600",
            "fax_number": "386-668-0031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 SUMMERHAVEN DR",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327132716",
            "telephone_number": "386-668-8600",
            "fax_number": "386-668-0031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERONE",
        "first_name": "JOSEPH",
        "middle_name": "V",
        "name_suffix": "Jr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "9410",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Debary, FL

Sources for this page

Verify at the official NPI Registry.