Provider Demographics
NPI:1518185552
Name:KALLIO, JENNIFER KAY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:KAY
Last Name:KALLIO
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:UNMC COLLEGE OF DENTISTRY 40TH AND HOLDREGE
Mailing Address - Street 2:PO BOX 830740
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68583-0740
Mailing Address - Country:US
Mailing Address - Phone:402-472-1344
Mailing Address - Fax:402-472-6681
Practice Address - Street 1:UNMC COLLEGE OF DENTISTRY 40TH AND HOLDREGE
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68583-0740
Practice Address - Country:US
Practice Address - Phone:402-472-1344
Practice Address - Fax:402-472-6681
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE6501122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist