Provider Demographics
NPI:1245618602
Name:BARRY, KYLE (DDS)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:BARRY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 BELLEVIEW AVE STE 100B
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-1410
Mailing Address - Country:US
Mailing Address - Phone:816-561-9666
Mailing Address - Fax:
Practice Address - Street 1:3933 N MAIZE RD STE 100
Practice Address - Street 2:
Practice Address - City:MAIZE
Practice Address - State:KS
Practice Address - Zip Code:67101-9619
Practice Address - Country:US
Practice Address - Phone:316-729-5670
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-18
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140227111223E0200X
KS615751223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics