=====================================================
General NPI Number Information
=====================================================
NPI Number | 1629291075
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | FRANK J CALVO DDS PS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 400 BOSTON STREET
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98109-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-284-7812
-----------------------------------------------------
Fax | 206-284-1139
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 400 BOSTON STREET
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98109-2127
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-284-7812
-----------------------------------------------------
Fax | 206-284-1139
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. FRANK J CALVO
-----------------------------------------------------
Credential | DDS
-----------------------------------------------------
Telephone | 206-284-7812
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 6456
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------