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General NPI Number Information
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NPI Number | 1588141055
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Entity Type | Individual
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Provider Name | KRISTIANA R KALIBAT D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/26/2018
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Last Update Date | 07/15/2025
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Provider Practice Location Address
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Address Line | SAGE DENTAL OF POLO GROUNDS, PLLC 956 S MILITARY TRL
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City | WEST PALM BEACH
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State | FL
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Zip | 33415
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Country | US
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Telephone | 561-359-6482
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Fax |
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Provider Business Mailing Address
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Address Line | 134 BALDWIN AVE APT 709
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City | JERSEY CITY
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State | NJ
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Zip | 07306-2085
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DI02720100
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DN23382
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License Number State | FL
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