MEDICARE: DR. KYLE W REYNOLDS D.M.D

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	122300000X	Dentist	8800	KY

General Provider Information

NPI Number	:	1730318924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KYLE W REYNOLDS D.M.D

Provider Business Mailing Address
First Line	:	725 ALEXANDRIA PIKE STE 100
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2169
Country	:	US
Telephone Number	:	859-781-0221
Fax Number	:

Provider Business Practice Location Address
First Line	:	725 ALEXANDRIA PIKE STE 100
Second Line	:
City	:	FORT THOMAS
State	:	KY
Zip	:	41075-2169
Country	:	US
Telephone Number	:	859-781-0221
Fax Number	:

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

Provider Enumeration Date	:	07/08/2009
Last Update Date	:	04/06/2026

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