MEDICARE: KYLE NIELD DDS LLC

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
1	122300000X	Dentist

General Provider Information

NPI Number	:	1487362422
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KYLE NIELD DDS LLC

Provider Business Mailing Address
First Line	:	310 OWING ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360
Country	:	US
Telephone Number	:	540-629-0302
Fax Number	:

Provider Business Practice Location Address
First Line	:	310 OWINGS ST
Second Line	:
City	:	LAURENS
State	:	SC
Zip	:	29360-2738
Country	:	US
Telephone Number	:	864-984-6888
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	KYLE NIELD
Credential	:	DDS
Telephone Number	:	540-629-0302

Provider Enumeration Date	:	11/08/2022
Last Update Date	:	09/17/2025

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