Provider Demographics
NPI:1003489584
Name:CALABRESE, ALAINA JO (DDS)
Entity Type:Individual
Prefix:
First Name:ALAINA
Middle Name:JO
Last Name:CALABRESE
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 1:4515 NE 63RD TER APT SUITE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64119-4726
Mailing Address - Country:US
Mailing Address - Phone:816-726-3513
Mailing Address - Fax:
Practice Address - Street 1:4100 NE VIVION RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64119-2811
Practice Address - Country:US
Practice Address - Phone:816-420-9070
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-21
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20210222191223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice