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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1376683714 | NPPES |
| New York | MEDICAID | 02168867 |
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