Jon Caldwell, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE60711516 Issued in WA

Practice address

115 Pelly Ave N
Renton, WA 98057-5714

Phone

(425) 226-3192

Fax

(425) 226-9848

NPI assigned

Mar 20, 2013

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Jon W Caldwell, DMD, PLLC

  • Dental Clinic/Center
  • Renton, WA
  • NPI 1962340075
  NPD Authorized official

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

{
    "created_epoch": "1363737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624924800000",
    "number": "1457693178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "425-226-3192",
            "fax_number": "425-226-9848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 PELLY AVE N",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980575714",
            "telephone_number": "425-226-3192",
            "fax_number": "425-226-9848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDWELL",
        "first_name": "JON",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-20",
        "last_updated": "2021-06-29",
        "certification_date": "2021-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60711516",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachelle Anne Ibanez Cadiz, OTD
• Hayley Ellen Cain McCaughan, MS, LGC
• Joy Delora Cain, LMFTA
• Letitia Renee Cain, N.D.
• Isela L Calderon
• Alexis Calliste
• Jeunesse Micelle Jane Palma Calsado, ARNP
• Courtney Elizabeth Campbell, M.S.W.
• Cynthia Louise Campbell, L.M.P.
• Nicole Jeanine Campbell, PHARMD

• General Practice Dentistry in Renton, WA
• Providers in Renton, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.