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NPI Code Detail

MEDICARE: REGAN AIELLO DDS

MEDICARE: REGAN AIELLO DDS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentist2023020648MO

General Provider Information

NPI Number : 1255025961
Entity Type Code : Individual
Provider Name (Legal Business Name) : REGAN AIELLO DDS
Provider Business Mailing Address
First Line : 2100 WYANDOTTE ST UNIT 1112
Second Line :
City : KANSAS CITY
State : MO
Zip : 64108-2581
Country : US
Telephone Number : 636-578-7868
Fax Number :
Provider Business Practice Location Address
First Line : 209 NE BARRY RD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-2721
Country : US
Telephone Number : 816-454-6443
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2023
Last Update Date : 06/06/2023

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Directions to “ REGAN AIELLO DDS” Practice Location

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