Provider Demographics
NPI:1538214580
Name:CAIRO, ALYSSA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALYSSA
Middle Name:
Last Name:CAIRO
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 1:7141 DEXTER PINCKNEY RD
Mailing Address - Street 2:
Mailing Address - City:DEXTER
Mailing Address - State:MI
Mailing Address - Zip Code:48130-9608
Mailing Address - Country:US
Mailing Address - Phone:734-424-1718
Mailing Address - Fax:734-424-1788
Practice Address - Street 1:7141 DEXTER PINCKNEY RD
Practice Address - Street 2:
Practice Address - City:DEXTER
Practice Address - State:MI
Practice Address - Zip Code:48130-9608
Practice Address - Country:US
Practice Address - Phone:734-424-1718
Practice Address - Fax:734-424-1788
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010179901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4861680Medicaid