Marcelo Eduardo Calderon, D.M.D.,P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

041073-1 Issued in NY

Practice address

13501 Lefferts Blvd
South Ozone Park, NY 11420-3601

Phone

(718) 845-6297

Fax

(718) 845-6563

NPI assigned

Apr 17, 2007

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1467677054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13501 LEFFERTS BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203601",
            "telephone_number": "718-845-6297",
            "fax_number": "718-845-6563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13501 LEFFERTS BLVD",
            "city": "SOUTH OZONE PARK",
            "state": "NY",
            "postal_code": "114203601",
            "telephone_number": "718-845-6297",
            "fax_number": "718-845-6563"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALDERON",
        "first_name": "MARCELO",
        "middle_name": "EDUARDO",
        "name_prefix": "Dr.",
        "credential": "D.M.D.,P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "041073-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01124010",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LOCATION # DORAL",
            "identifier": "006709",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rosemarie Olive Buckley, RN
• Louise Burkhead, LMSW
• Arita Ashley Busgith, FNP
• Joseph John Calabrese, LMSW
• Jamilet Calderon, LMHC-D
• Nicole Caputo, LCSW
• Caringhands Physical Therapy
• Carroll Ann Mendonca PT PC
• Susan Carter
• Cath Char Nghbhd SVS Caldwell Icf

• General Practice Dentistry in South Ozone Park, NY
• Providers in South Ozone Park, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.