Calderon, Mike E

Calderon, Mike E is an individual health care provider with primary practice located at 720 Montauk Hwy , West Islip NY 11795-4411. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / Oral and Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Calderon, Mike E can be contacted via phone (631) 666-1392.

Contact Information

Primary practice address
720 Montauk Hwy West Islip NY 11795-4411
Phone: (631) 666-1392
Fax: (631) 666-1520
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 045 794 New York
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 045794 New York

Profile Details

NPI number 1376683714
LBN Legal business name Calderon, Mike E
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 7th, 2007
Last updated Apr 29th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376683714 NPPES
New York MEDICAID 02168867

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