Active NPI
Emelito Tapang Calderon, DDS
- General Practice Dentistry
- Northridge, CA
National Provider Identifier
1578786281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 47458
- Practice address
- 9036 Reseda Blvd
Suite 102
Northridge, CA 91324-5897 - Phone
- (818) 701-5210
- Fax
- (818) 701-5208
- NPI assigned
- Apr 11, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 47458 | CA | Primary |
Addresses
Primary practice location
9036 Reseda Blvd
Suite 102
Northridge, CA 91324-5897
Mailing address
9036 Reseda Blvd
Suite 102
Northridge, CA 91324-5897
Phone (818) 701-5210
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| G9384401 | Medicaid | CA |
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 |
|---|---|---|---|
| 47458 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176249600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578786281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9036 RESEDA BLVD",
"address_2": "SUITE 102",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913245897",
"telephone_number": "818-701-5210",
"fax_number": "818-701-5208"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9036 RESEDA BLVD",
"address_2": "SUITE 102",
"city": "NORTHRIDGE",
"state": "CA",
"postal_code": "913245897",
"telephone_number": "818-701-5210",
"fax_number": "818-701-5208"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CALDERON",
"first_name": "EMELITO",
"middle_name": "TAPANG",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "47458",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "G9384401",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Northridge, CA
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.