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General NPI Number Information
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NPI Number | 1952813727
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Entity Type | Individual
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Provider Name | FALLON ANDREA CUNNINGHAM DDS
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Gender | Female
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Dates
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Enumeration Date | 11/01/2017
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Last Update Date | 08/26/2025
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Provider Practice Location Address
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Address Line | 13519 MICHIGAN AVE
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City | DEARBORN
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State | MI
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Zip | 48126-3510
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Country | US
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Telephone | 313-633-9318
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Fax |
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Provider Business Mailing Address
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Address Line | 8956 162ND ST FL 3
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City | JAMAICA
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State | NY
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Zip | 11432-5072
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Country | US
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Telephone | 718-657-1100
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Fax | 718-657-1870
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 060687
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 2901602780
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License Number State | MI
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