Individual provider Active NPI

Malvin Tom Calimlim, D.D.S.

  • General Practice Dentistry
  • Reynoldsburg, OH
National Provider Identifier
1992989818
Registry record updated Dec 27, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30-022217 Issued in OH
Practice address
6323 Tussing Rd
Reynoldsburg, OH 43068-3984
Phone
(614) 863-2222
NPI assigned
Dec 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30-022217 OH
General Practice Dentistry 1223G0001X 30-022217 OH Primary

Addresses

Primary practice location

6323 Tussing Rd
Reynoldsburg, OH 43068-3984

Mailing address

6323 Tussing Rd
Reynoldsburg, OH 43068-3984
Phone (614) 863-2222

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160425001659 OH Order and Referring Only - DentistPractitioner - Dentist 1951600014

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-022217OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1198713600000",
    "number": "1992989818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6323 TUSSING RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683984",
            "telephone_number": "614-863-2222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6323 TUSSING RD",
            "city": "REYNOLDSBURG",
            "state": "OH",
            "postal_code": "430683984",
            "telephone_number": "614-863-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALIMLIM",
        "first_name": "MALVIN",
        "middle_name": "TOM",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2007-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-022217",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-022217",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Reynoldsburg, OH

Sources for this page

Verify at the official NPI Registry.