Provider Demographics
NPI:1619866076
Name:HARVEY, KYLE ZACHARY (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:ZACHARY
Last Name:HARVEY
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 1:420 E CHURCH ST UNIT 620
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32801-2789
Mailing Address - Country:US
Mailing Address - Phone:813-924-5973
Mailing Address - Fax:
Practice Address - Street 1:1915 MAGUIRE RD STE 101
Practice Address - Street 2:
Practice Address - City:WINDERMERE
Practice Address - State:FL
Practice Address - Zip Code:34786-7938
Practice Address - Country:US
Practice Address - Phone:321-603-3030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL305571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice