Healthcare Provider Details

I. General information

NPI: 1235704289
Provider Name (Legal Business Name): COLETON CALDWELL DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5571 NW BARRY RD
KANSAS CITY MO
64154-1408
US

IV. Provider business mailing address

5571 NW BARRY RD
KANSAS CITY MO
64154-1408
US

V. Phone/Fax

Practice location:
  • Phone: 316-208-9061
  • Fax:
Mailing address:
  • Phone: 816-587-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. COLETON ALLEN CALDWELL
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 316-208-9061