Provider Demographics
NPI:1659054963
Name:CALDER, JOSHUA THOMAS (DDS)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:THOMAS
Last Name:CALDER
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 1:17945 PLATEAU RD
Mailing Address - Street 2:
Mailing Address - City:SONORA
Mailing Address - State:CA
Mailing Address - Zip Code:95370-8900
Mailing Address - Country:US
Mailing Address - Phone:801-678-7410
Mailing Address - Fax:
Practice Address - Street 1:17961 PLATEAU RD
Practice Address - Street 2:
Practice Address - City:SONORA
Practice Address - State:CA
Practice Address - Zip Code:95370-8900
Practice Address - Country:US
Practice Address - Phone:209-586-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-11
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10-90351223G0001X
CA1090351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty