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NPI Code Detail

MEDICARE: DR. KEVIN LYNN PAYTON D.D.S.

MEDICARE:  DR. KEVIN LYNN PAYTON  D.D.S.
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
11223S0112XOral and Maxillofacial Surgery (Dentist)DN11666FL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
363054XOTHERFLMEDICARE ID

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1592043705OTHERFLTAX ID
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1174587315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN LYNN PAYTON D.D.S.
Provider Business Mailing Address
First Line : 3300 S UNIVERSITY DR STE 7153
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33328-2004
Country : US
Telephone Number : 954-262-7153
Fax Number : 954-262-1793
Provider Business Practice Location Address
First Line : 3300 S UNIVERSITY DR STE 7153
Second Line :
City : FT LAUDERDALE
State : FL
Zip : 33328-2004
Country : US
Telephone Number : 954-262-7153
Fax Number : 954-262-1793
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2006
Last Update Date : 08/21/2025

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