Provider Demographics
NPI:1750874426
Name:KALOTA, ORUSA (DMD)
Entity type:Individual
Prefix:DR
First Name:ORUSA
Middle Name:
Last Name:KALOTA
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 1:550 FULLERTON AVE UNIT 88815
Mailing Address - Street 2:
Mailing Address - City:CAROL STREAM
Mailing Address - State:IL
Mailing Address - Zip Code:60188-5409
Mailing Address - Country:US
Mailing Address - Phone:630-229-9606
Mailing Address - Fax:
Practice Address - Street 1:849 S SUTTON RD
Practice Address - Street 2:
Practice Address - City:BARTLETT
Practice Address - State:IL
Practice Address - Zip Code:60103-1629
Practice Address - Country:US
Practice Address - Phone:630-372-9800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-07
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.031664122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist