Provider Demographics
NPI:1700629276
Name:ALLISON, LAURYN (DDS)
Entity type:Individual
Prefix:DR
First Name:LAURYN
Middle Name:
Last Name:ALLISON
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 1:4515 WALNUT ST APT 315C
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-7740
Mailing Address - Country:US
Mailing Address - Phone:417-225-8116
Mailing Address - Fax:
Practice Address - Street 1:801 W 47TH ST STE 110
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64112-1253
Practice Address - Country:US
Practice Address - Phone:816-931-2191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-13
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20240189841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice