Provider Demographics
NPI:1699061473
Name:REYNOLDS, KYLE T (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:T
Last Name:REYNOLDS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:809 N FRANKFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79416-1568
Mailing Address - Country:US
Mailing Address - Phone:806-796-2408
Mailing Address - Fax:806-686-6246
Practice Address - Street 1:809 N FRANKFORD AVE
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79416-1568
Practice Address - Country:US
Practice Address - Phone:806-796-2408
Practice Address - Fax:806-686-6246
Is Sole Proprietor?:No
Enumeration Date:2011-06-21
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002032331223P0221X
TX357671223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry