KYLE NELSON (NPI# 1821356841) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1821356841 |
| Entity Type | Individual |
| Full Name | KYLE NELSON |
| Credential | DDS, MS |
| Practice Address |
1 Wahoo Ave Groton CT 06349-2324 |
| Practice Telephone | 8606943736 |
| Mailing Telephone | 6086943736 |
| Enumeration Date | 2012-04-27 |
| Last Update Date | 2019-09-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
12238 | CT | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 70 Howard St Ste B, New London, CT 063204937 | 8604472572 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316998180 | Kyle K Nelson | Family Medicine | 1520 Whitehall Rd, Anderson, SC 29625-1916 | 2006-05-15 |
| 1306307335 | Kyle Fitzgerald Nelson | Student in an Organized Health Care Education/Training Program | 1 Gustave L Levy Pl, New York, NY 10029-6504 | 2019-03-31 |
| 1942773452 | Kyle Nelson | Physical Therapist | 50 E Foothill Blvd Ste 100, Arcadia, CA 91006-2314 | 2019-01-07 |
| 1043783871 | Kyle R Nelson | Physical Therapy Assistant | 1621 Coit Rd, Plano, TX 75075-6141 | 2019-01-03 |
| 1417473539 | Kyle Nelson | Physical Therapist | 350 Posada Ln Ste 103, Templeton, CA 93465-4061 | 2017-08-21 |
| 1386190064 | Kyle Nelson | Occupational Therapist | 2101 Wooddale Dr, Suite A, Woodbury, MN 55125-4441 | 2016-08-31 |
| 1508220039 | Kyle Nelson | Registered Nurse | 900 Peeler St, Kalamazoo, MI 49008-2300 | 2016-04-11 |
| 1912385865 | Kyle Nelson | Respiratory Therapist, Registered | 400 Fort Hill Ave, Canandaigua, NY 14424-1159 | 2015-05-12 |
| 1891012449 | Kyle Nelson | Family Medicine | 2801 W Kinnickinnic River Pkwy, Milwaukee, WI 53215-3669 | 2010-04-22 |
| 1194987289 | Kyle Shaune Nelson | Neurological Surgery | 11850 Blackfoot St Nw, Suite 490, Coon Rapids, MN 55433-2578 | 2008-06-30 |
| Street Address |
1 WAHOO AVE |
| City | GROTON |
| State | CT |
| Zip Code | 06349-2324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043207004 | Matthew Braden Burns Miller | Dentist | 1 Wahoo Ave, Groton, CT 06349 | 2005-10-04 |
| 1063027407 | Jimmy Nazih Suliman | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-09-12 |
| 1790395242 | Duc-nhan Nguyen Pham | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-08-08 |
| 1770112708 | Amanda Kathleen Dobyns | Occupational Therapist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2020-04-02 |
| 1831732825 | Cody Clark | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-10-22 |
| 1477103059 | Jordan Taylor Rucinski | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-09-16 |
| 1699335372 | Cynthia Daigneault | Counselor | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-06-16 |
| 1942868211 | Cameron Anson Martin | Military Health Care Provider | 1 Wahoo Ave, Groton, CT 06340 | 2019-06-03 |
| 1104386903 | Zena Sabath | General Practice | 1 Wahoo Ave, Groton, CT 06349-2324 | 2019-03-20 |
| 1538636527 | Winston Eugene Young | Dentist | 1 Wahoo Ave, Groton, CT 06349-2324 | 2018-10-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205434347 | Mvca | Optometrist | Navy Submarine Base New London, Bldg 484, Groton, CT 06349 | 2020-10-12 |
| 1376194274 | Christopher Lee Roy Smith | Military Health Care Provider | Uss San Juan (ssn 751), Groton, CT 06349 | 2019-09-23 |
| 1588127575 | Morgan Ross Jones | Student in an Organized Health Care Education/Training Program | Bx 159 Navsubase Nlon, Groton, CT 06349 | 2019-04-08 |
| 1689179640 | David Saunders | Military Health Care Provider | 159 Navsubase Nlon, Groton, CT 06349 | 2018-03-29 |
| 1013264423 | Dennis Buenaventura Custodio | Military Health Care Provider | 69 Trout Ave, Naval Undersea Medical Institute, Groton, CT 06349 | 2012-08-06 |
| 1609013549 | Nicolas David Mendoza | Military Health Care Provider | Uss Hawaii (ssn 776), Fpo, AE 06349 | 2009-01-14 |
| 1881843084 | Mark Francis Jarvis | Military Health Care Provider | Nssc Nlon, Bldg 76, Groton, CT 06349 | 2008-09-11 |
| 1780882738 | Michael Nutt | Military Health Care Provider | Bldg 517 Taugtog Ave, Navsubscol, Groton, CT 06349 | 2007-07-10 |
| 1497811343 | Keith Benjamin Hoekman | Nurse Practitioner | 1 Wahoo Dr, Groton, CT 06349 | 2006-12-28 |
| 1881604163 | Christina E Toufexis | Pediatrics | 1 Wahoo Drive, Groton, CT 06349 | 2006-08-09 |
| Find all providers in zip 06349 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093894578 | Thomas Matthew Goebel | Dentist | 491 Route 184, Suite 200, Groton, CT 06340 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073041489 | Endodontic Solutions LLC | Dentist | 19 Ensign Dr, Avon, CT 06001-3705 | 2017-05-30 |
| 1871937359 | Lester C Reid | Dentist | 225 N Main St Ste 209, Bristol, CT 06010-4993 | 2013-04-26 |
| 1225399108 | Endodontic Specialists LLC | Dentist | 2 Chucrh St # 670, Ellington, CT 06029-0670 | 2012-06-06 |
| 1669751939 | Professional Endodontics Ll | Dentist | 70 Howard St, Suite B, New London, CT 06320-4937 | 2011-08-04 |
| 1538392170 | Wolcott Street Dental-2, PC | Dentist | 144 Boston Ave, Bridgeport, CT 06610-1604 | 2009-08-31 |
| 1134359623 | Wolcott Street Dental-2, PC | Dentist | 728 Wolcott Street, Waterbury, CT 06705 | 2009-07-20 |
| 1568603934 | Wolcott Street Dental-1, PC | Dentist | 531 Elm St, New Haven, CT 06511-4549 | 2009-03-16 |
| 1952548208 | Rachele Luciano | Dentist | 366 Middle Tpke W, Manchester, CT 06040-3824 | 2009-01-08 |
| 1912156514 | Care Endodontics, P.C. | Dentist | 436 Farmington Ave, Hartford, CT 06105-4423 | 2008-09-18 |
| 1295993269 | New England Dental | Dentist | 54 Main St # F, Danbury, CT 06810-3009 | 2008-05-27 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.