Ronald Calaway-Habeck, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

019026855 Issued in IL

Practice address

2800 College Ave
Alton, IL 62002-4742

Phone

(618) 474-7000

NPI assigned

Apr 26, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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.

• Lifetime Dental Care of Illinois, PC

  • General Practice Dentistry
  • Columbia, IL
  • NPI 1831311158
  NPD (past)

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

{
    "created_epoch": "1177545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1457571994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7310 TIMBERCREST DR",
            "city": "GODFREY",
            "state": "IL",
            "postal_code": "62035",
            "telephone_number": "618-567-8829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2800 COLLEGE AVE",
            "city": "ALTON",
            "state": "IL",
            "postal_code": "620024742",
            "telephone_number": "618-474-7000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALAWAY-HABECK",
        "first_name": "RONALD",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-26",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019026855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anne Marie Byrnes, AU.D.
• C. David Brickman, DDS, Ms, PC
• Lisa A Cagle, D.M.D.
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• Ashley Lynn Cain
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• Kelley Renee Campbell, RN, FNP-BC
• Susan Campbell, MA
• Zoe Campbell
• Nathan Campo

• Dentist in Alton, IL
• Providers in Alton, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2024; 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.