MEDICARE: COREY KYOIL BIRCH DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QS1000X	Student Health Clinic/Center		TX

General Provider Information

NPI Number	:	1144165424
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	COREY KYOIL BIRCH DMD

Provider Business Mailing Address
First Line	:	12717 TIERRA ARLETH DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4849
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12717 TIERRA ARLETH DR
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-4849
Country	:	US
Telephone Number	:	915-549-7046
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/22/2026
Last Update Date	:	04/22/2026

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