Provider Demographics
NPI:1023041985
Name:CALDERON, STEVEN H (DMD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:H
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 1:45 LANSING DR
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2735
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:62 WASHINGTON ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-2735
Practice Address - Country:US
Practice Address - Phone:518-463-9809
Practice Address - Fax:518-434-2595
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0489911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000414751001OtherBSNENY