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General NPI Number Information
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NPI Number | 1841784832
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Entity Type | Individual
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Provider Name | KYLE DIRENZO DMD
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Gender | Male
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 12/11/2025
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Provider Practice Location Address
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Address Line | 2240 S HURON PKWY
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City | ANN ARBOR
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State | MI
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Zip | 48104-5151
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Country | US
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Telephone | 734-677-2156
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Fax | 734-704-0006
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Provider Business Mailing Address
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Address Line | 1734 BARRINGTON PL
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City | ANN ARBOR
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State | MI
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Zip | 48103-5607
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Country | US
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Telephone |
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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 | 122300000X
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Taxonomy Name | Dentist
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License Number | 2901022658
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License Number State | MI
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