Healthcare Provider Details

I. General information

NPI: 1932517422
Provider Name (Legal Business Name): KYLE REED DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2014
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1516 KANAWHA BLVD W
CHARLESTON WV
25387-2533
US

IV. Provider business mailing address

1516 KANAWHA BLVD W
CHARLESTON WV
25387-2533
US

V. Phone/Fax

Practice location:
  • Phone: 304-345-7272
  • Fax: 304-345-7287
Mailing address:
  • Phone: 304-345-7272
  • Fax: 304-345-7287

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4104
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: