Provider Demographics
NPI:1609663608
Name:HOLLENBECK, ALLYSON
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:
Last Name:HOLLENBECK
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:129 NW MOCK AVE UNIT 3309
Mailing Address - Street 2:
Mailing Address - City:BLUE SPRINGS
Mailing Address - State:MO
Mailing Address - Zip Code:64014-2562
Mailing Address - Country:US
Mailing Address - Phone:480-262-9971
Mailing Address - Fax:
Practice Address - Street 1:811 S BUSINESS HIGHWAY 13 STE A
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:MO
Practice Address - Zip Code:64067-1572
Practice Address - Country:US
Practice Address - Phone:660-251-6440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2025012442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist