Provider Demographics
NPI:1487362422
Name:KYLE NIELD DDS LLC
Entity type:Organization
Organization Name:KYLE NIELD DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NIELD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:540-629-0302
Mailing Address - Street 1:6744 BAY HILL CT
Mailing Address - Street 2:
Mailing Address - City:RADFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24141-5675
Mailing Address - Country:US
Mailing Address - Phone:540-629-0302
Mailing Address - Fax:
Practice Address - Street 1:310 OWINGS ST
Practice Address - Street 2:
Practice Address - City:LAURENS
Practice Address - State:SC
Practice Address - Zip Code:29360-2738
Practice Address - Country:US
Practice Address - Phone:864-984-6888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty