Provider Demographics
NPI:1881261071
Name:MYERS-MASSEY, KAYLAN BLAIR (DDS)
Entity type:Individual
Prefix:DR
First Name:KAYLAN
Middle Name:BLAIR
Last Name:MYERS-MASSEY
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 1:3493 SWICEGOOD RD
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:NC
Mailing Address - Zip Code:27299-9006
Mailing Address - Country:US
Mailing Address - Phone:336-425-6461
Mailing Address - Fax:
Practice Address - Street 1:242 N TALBERT BLVD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27292-4143
Practice Address - Country:US
Practice Address - Phone:336-249-2908
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC122441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice