Provider Demographics
NPI:1366602013
Name:RANTA STRAIT, KYLE MICHELE (DDS)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:MICHELE
Last Name:RANTA STRAIT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KYLE
Other - Middle Name:MICHELE
Other - Last Name:PLATSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1415 NORTH STREET
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-994-8807
Mailing Address - Fax:
Practice Address - Street 1:10601 PECAN PARK BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750
Practice Address - Country:US
Practice Address - Phone:512-823-0077
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-16
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019027645122300000X
TX27224122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist