Kyle William Odom, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3099-99 Issued in MS

Practice address

435 MDG
Unit 3215
Apo, AE 09094
DE

Phone

01149637146

NPI assigned

Oct 4, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Oral Surgery Kansas, LC

  • Oral and Maxillofacial Surgery (Dentist)
  • Lawrence, KS
  • NPI 1144304643
  NPD (past)

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295722452",
    "addresses": [
        {
            "country_code": "DE",
            "country_name": "Germany",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "435 MDG",
            "address_2": "UNIT 3215",
            "city": "APO",
            "state": "AE",
            "postal_code": "09094",
            "telephone_number": "01149637146"
        },
        {
            "country_code": "DE",
            "country_name": "Germany",
            "address_purpose": "LOCATION",
            "address_type": "FGN",
            "address_1": "435 MDG",
            "address_2": "UNIT 3215",
            "city": "APO",
            "state": "AE",
            "postal_code": "09094",
            "telephone_number": "01149637146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOM",
        "first_name": "KYLE",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3099-99",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.