Kyle Wayne Heine, DMD

Individual provider Active NPI General Practice Dentistry · Metropolis, IL

NPI 1043398258 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1043398258
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
Practice address
44 Jon St
Metropolis, IL 62960
Phone
(618) 524-7303
Fax
(618) 524-4805
NPI assigned
Nov 2, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
019024337ILMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kyle W Heine DMD PC Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X IL Yes

Addresses

Primary practice location

44 Jon St
Metropolis, IL 62960

Mailing address

44 Jon St
Metropolis, IL 62960
Phone (618) 524-7303

Other providers in Metropolis, IL

All providers in Metropolis, IL · General Practice Dentistry in Illinois

Sources for this page

Verify at the official NPI Registry.