Active NPI
Jacqueline Alicia Calcagno, D.M.D.
- Pediatric Dentistry
- San Diego, CA
National Provider Identifier
1528447398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 104145
- Practice address
- 5627 Oberlin Dr Ste 100
San Diego, CA 92121-3748 - Phone
- (858) 452-7272
- NPI assigned
- May 26, 2015
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 15890 | MD | |
| Pediatric Dentistry | 1223P0221X | 104145 | CA | Primary |
Addresses
Primary practice location
5627 Oberlin Dr Ste 100
San Diego, CA 92121-3748
Mailing address
13350 Pacific PL Unit 2302
San Diego, CA 92130-8229
Phone (732) 977-4568
Other practice location 1
8722 Flower Ave
Suite 7
Silver Spring, MD 20901-4000
Phone (301) 588-9548
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 |
|---|---|---|---|
| 15890 | MD | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr Pablo a Figueredo & Assoc PC | Dentist | Past | Accepting new patients |
| Howard R Dixon | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba San Diego Pediatric Dental Group
- Pediatric Dentistry
- San Diego, CA
- NPI 1235451782
-
- Dentist
- Silver Spring, MD
- NPI 1700935194
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1432598400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565222400000",
"number": "1528447398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13350 PACIFIC PL UNIT 2302",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921308229",
"telephone_number": "732-977-4568"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5627 OBERLIN DR STE 100",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921213748",
"telephone_number": "858-452-7272"
}
],
"practiceLocations": [
{
"address_1": "8722 Flower Ave",
"address_2": "Suite 7",
"address_purpose": "LOCATION",
"city": "Silver Spring",
"state": "MD",
"postal_code": "209014000",
"country_code": "US",
"telephone_number": "301-588-9548",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CALCAGNO",
"first_name": "JACQUELINE",
"middle_name": "ALICIA",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-05-26",
"last_updated": "2019-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MD",
"license": "15890",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "104145",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.