Provider Demographics
NPI:1558468413
Name:CALCAGNO, JAMES C (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:C
Last Name:CALCAGNO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4100 PORTOLA DR
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-4500
Mailing Address - Country:US
Mailing Address - Phone:831-475-4100
Mailing Address - Fax:
Practice Address - Street 1:4100 PORTOLA DR
Practice Address - Street 2:SUITE 2
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-4500
Practice Address - Country:US
Practice Address - Phone:831-475-4100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA356841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice