Dr. Ronald Calaway-Habeck, DMD
Dentist in Alton, IL. Individual provider (NPI-1).
NPI number1457571994
StatusActive
Last updated in NPPESFeb 19, 2024
Details
- NPI
- 1457571994
- Entity type
- Individual (NPI-1)
- Name
- Dr. Ronald Calaway-Habeck
- Credential
- DMD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 26, 2007
- Certification date
- Feb 19, 2024
- Last updated
- Feb 19, 2024
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · ORDER AND REFERRING ONLY - DENTIST
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility No · Hospice Yes
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 019026855 | IL | Yes |
Practice location
2800 College AveAlton, IL 62002-4742
Phone 618-474-7000
Mailing address
7310 Timbercrest DrGodfrey, IL 62035
Phone 618-567-8829
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