Provider Demographics
NPI:1326656554
Name:MAJNARICH, KYLE R (DMD)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:R
Last Name:MAJNARICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 STARLITE DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:KY
Mailing Address - Zip Code:42420-6102
Mailing Address - Country:US
Mailing Address - Phone:270-826-1414
Mailing Address - Fax:
Practice Address - Street 1:344 HEARD STREET
Practice Address - Street 2:BUILDING 556
Practice Address - City:SCHOFIELD BARRACKS
Practice Address - State:HI
Practice Address - Zip Code:96857
Practice Address - Country:US
Practice Address - Phone:808-433-6825
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-14
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY112571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice