Healthcare Provider Details

I. General information

NPI: 1992614960
Provider Name (Legal Business Name): GENTLE DENTAL STREETSBORO, DR. ALWILLEED KALOUT DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9889 STATE ROUTE 43 STE A
STREETSBORO OH
44241-4985
US

IV. Provider business mailing address

9889 STATE ROUTE 43 STE A
STREETSBORO OH
44241-4985
US

V. Phone/Fax

Practice location:
  • Phone: 440-322-1917
  • Fax: 440-322-1918
Mailing address:
  • Phone: 440-322-1917
  • Fax: 440-322-1918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: ALWILLEED KALOUT
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 440-571-1279