Active NPI
Carol S Calicdan, DDS
- Dentist
- Upland, CA
National Provider Identifier
1205042322
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 49732
- Practice address
- 1227 W Foothill Blvd
Upland, CA 91786-3681 - Phone
- (909) 981-5083
- Fax
- (909) 981-4213
- NPI assigned
- May 15, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 49732 | CA | Primary |
Addresses
Primary practice location
1227 W Foothill Blvd
Upland, CA 91786-3681
Mailing address
1227 W Foothill Blvd
Upland, CA 91786-3681
Phone (909) 981-5083
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 49732 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1205042322",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1227 W FOOTHILL BLVD",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863681",
"telephone_number": "909-981-5083",
"fax_number": "909-981-4213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1227 W FOOTHILL BLVD",
"city": "UPLAND",
"state": "CA",
"postal_code": "917863681",
"telephone_number": "909-981-5083",
"fax_number": "909-981-4213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALICDAN",
"first_name": "CAROL",
"middle_name": "S",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "49732",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Upland, CA
- Cajon Medical Group, PC
- Anna Lilia Calcanas, LMFT
- Calcare Hospice LLC
- Moira Cale, FNP
- Calicdan-Sta.Ana DDS Corp
- California Clinical, Assessment, Restoration and Evaluation, a Professional Psychological Corp
- California Clinics, Inc
- California Desert Hospice & Palliative Care, Inc.
- California Radiology Management Inc
- California State Home Health Care, LLC.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.