Kylee Brightside DDS PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

KYLEE BRIGHTSIDE DDS PLLC

Practice address

1161 S Perry St Ste B100
Castle Rock, CO 80104-1978

Phone

(720) 799-1445

NPI assigned

Aug 22, 2019

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Kylee Brightside, DDS

Title

Owner

Phone

(720) 799-1445

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1566432000000",
    "number": "1245887488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1161 S PERRY ST STE B100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041978",
            "telephone_number": "720-799-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1161 S PERRY ST STE B100",
            "city": "CASTLE ROCK",
            "state": "CO",
            "postal_code": "801041978",
            "telephone_number": "720-799-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLEE BRIGHTSIDE DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A",
        "authorized_official_last_name": "BRIGHTSIDE",
        "authorized_official_first_name": "KYLEE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "720-799-1445",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740625730",
            "state": "CO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@brightsidedentistry.net",
            "affiliation": "N",
            "address_1": "1161 S Perry St Ste B100",
            "city": "Castle Rock",
            "state": "CO",
            "country_code": "US",
            "postal_code": "801041978",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.