Healthcare Provider Details

I. General information

NPI: 1437078086
Provider Name (Legal Business Name): ADEYEMI ISAIAH FALEGAN DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2026
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NE CORONADO DR
BLUE SPRINGS MO
64014-2944
US

IV. Provider business mailing address

9015 BOOTH AVE
KANSAS CITY MO
64138-4436
US

V. Phone/Fax

Practice location:
  • Phone: 816-622-3866
  • Fax:
Mailing address:
  • Phone: 816-622-3866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026031776
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: