Healthcare Provider Details

I. General information

NPI: 1396544169
Provider Name (Legal Business Name): KAYLA MICHELLE NERO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2025
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 PORTAGE ST
DOYLESTOWN OH
44230
US

IV. Provider business mailing address

25 PORTAGE ST
DOYLESTOWN OH
44230
US

V. Phone/Fax

Practice location:
  • Phone: 330-658-6983
  • Fax:
Mailing address:
  • Phone: 330-658-6983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.028270
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: