Provider Demographics
NPI:1508908559
Name:CALDERON, KARIN LISBETH (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARIN
Middle Name:LISBETH
Last Name:CALDERON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 920581
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79902-0011
Mailing Address - Country:US
Mailing Address - Phone:205-422-0972
Mailing Address - Fax:
Practice Address - Street 1:1800 MCRAE BLVD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-6706
Practice Address - Country:US
Practice Address - Phone:915-592-4186
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX229901223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1902662OtherUNITED CONCORDIA