DR. ALITA PELTIER CALDWELL (DDS, MD) – Oral and Maxillofacial Surgery (Dentist), NPI 1477057818
Oral and Maxillofacial Surgery (Dentist)
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
90 ORAL SURGERY in MI
Provider Addresses for DR. ALITA PELTIER CALDWELL (DDS, MD)
4201 SAINT ANTOINE ST
DETROIT, MI 482012153
Phone: (269) 364-5379
Type: Location
1959 NE PACIFIC STREET BOX 357134
SEATTLE, WA 981950001
Phone:
Type: Mailing
University of Washington Medical Center - Montlake, 1959, Northeast Pacific Street, University District, Seattle, King County, Washington, 98195, United States
SEATTLE, WA 98195
Phone: (269) 364-5379
Type: Location
820 MONROE AVE NW APT 203
GRAND RAPIDS, MI 495031418
Phone:
Type: Mailing
1500 S MAIN ST
FORT WORTH, TX 761044917
Phone: (817) 702-3000
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-11-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20251105000340 | I | Oral Surgery | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 48201)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Maxillofacial Surgery, Oral Surgery | TX | |
| - | TX | |
| Maxillofacial Surgery, Oral Surgery, Plastic And Reconstructive Surgery, Vascular Surgery | TX | |
| Oral Surgery | TX | |
| Oral Surgery | TX | |
| Maxillofacial Surgery | TX | |
| Maxillofacial Surgery | TX | |
| - | CA | |
| - | TX | |
| - | TX |
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