Healthcare Provider Details

I. General information

NPI: 1669555975
Provider Name (Legal Business Name): WILLIAM R KAYE D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 BEECHER RD SUITE A
GAHANNA OH
43230-1797
US

IV. Provider business mailing address

420 BEECHER RD SUITE A
GAHANNA OH
43230-1797
US

V. Phone/Fax

Practice location:
  • Phone: 614-775-0222
  • Fax: 614-775-0824
Mailing address:
  • Phone: 614-775-0222
  • Fax: 614-775-0824

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number16969
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: