Provider Demographics
NPI:1710338314
Name:DARLING, ALYSSA (DMD)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:DARLING
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S MARKET ST
Mailing Address - Street 2:
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2946
Mailing Address - Country:US
Mailing Address - Phone:641-683-5773
Mailing Address - Fax:641-682-0484
Practice Address - Street 1:201 S MARKET ST
Practice Address - Street 2:
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2946
Practice Address - Country:US
Practice Address - Phone:641-683-5773
Practice Address - Fax:641-682-0484
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-24
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILD001271223G0001X
IADDS-09975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice