Provider Demographics
NPI:1053534099
Name:CALIRI, SUSAN ELAINE (DDS)
Entity type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELAINE
Last Name:CALIRI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:851 DWIGHT WAY
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94710-2424
Mailing Address - Country:US
Mailing Address - Phone:510-845-2864
Mailing Address - Fax:510-845-1920
Practice Address - Street 1:851 DWIGHT WAY
Practice Address - Street 2:
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94710-2424
Practice Address - Country:US
Practice Address - Phone:510-845-2864
Practice Address - Fax:510-845-1920
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA337311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice