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General NPI Number Information
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NPI Number | 1548902240
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Entity Type | Individual
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Provider Name | KYLE T. DORITY DMD
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Gender | Male
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Dates
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Enumeration Date | 04/12/2022
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Last Update Date | 08/25/2025
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Provider Practice Location Address
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Address Line | 4886 ROSEBUD LN
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City | NEWBURGH
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State | IN
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Zip | 47630-9351
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Country | US
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Telephone | 812-473-4833
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Fax |
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Provider Business Mailing Address
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Address Line | 8106 ARBOR MEADOW WAY
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City | LOUISVILLE
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State | KY
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Zip | 40228-4412
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Country | US
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Telephone | 435-770-5302
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 1204677A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 10789
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License Number State | KY
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