Provider Demographics
NPI:1740625730
Name:BRIGHTSIDE, KYLEE (DDS)
Entity type:Individual
Prefix:
First Name:KYLEE
Middle Name:
Last Name:BRIGHTSIDE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1161 S PERRY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:CO
Mailing Address - Zip Code:80104-1981
Mailing Address - Country:US
Mailing Address - Phone:720-799-1445
Mailing Address - Fax:
Practice Address - Street 1:1161 S PERRY ST STE 100
Practice Address - Street 2:
Practice Address - City:CASTLE ROCK
Practice Address - State:CO
Practice Address - Zip Code:80104-1981
Practice Address - Country:US
Practice Address - Phone:720-799-1445
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002022771223G0001X
CO002022771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice