Provider Demographics
NPI:1215767470
Name:KAYLAN B. MYERS-MASSEY, DDS, PLLC
Entity type:Organization
Organization Name:KAYLAN B. MYERS-MASSEY, DDS, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWENR/DENTSIT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAYLAN
Authorized Official - Middle Name:BLAIR
Authorized Official - Last Name:MYERS-MASSEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:336-425-6461
Mailing Address - Street 1:242 N TALBERT BLVD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27292-4143
Mailing Address - Country:US
Mailing Address - Phone:336-249-2908
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:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty