Provider Demographics
NPI:1942596416
Name:CALDERON, ERIK O (DMD)
Entity Type:Individual
Prefix:DR
First Name:ERIK
Middle Name:O
Last Name:CALDERON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5401 COLLINS AVE APT 1407
Mailing Address - Street 2:
Mailing Address - City:MIAMI BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33140-2536
Mailing Address - Country:US
Mailing Address - Phone:305-951-9988
Mailing Address - Fax:305-823-2761
Practice Address - Street 1:5401 COLLINS AVE APT 1407
Practice Address - Street 2:
Practice Address - City:MIAMI BEACH
Practice Address - State:FL
Practice Address - Zip Code:33140-2536
Practice Address - Country:US
Practice Address - Phone:305-951-9988
Practice Address - Fax:305-823-2761
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2016-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19377122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist