Provider Demographics
NPI:1790214948
Name:HALL, CAITLYN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CAITLYN
Middle Name:
Last Name:HALL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CAITLYN
Other - Middle Name:
Other - Last Name:LAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8305 NE WITT RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:MO
Mailing Address - Zip Code:64429-8028
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2000 SWIFT AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3424
Practice Address - Country:US
Practice Address - Phone:816-471-2911
Practice Address - Fax:816-527-9219
Is Sole Proprietor?:No
Enumeration Date:2017-06-09
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20170178841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice