Individual provider Active NPI

Kyle Lester Pabustan Viloria, D.D.S.

  • Dentist
  • Charlotte, NC
National Provider Identifier
1346600376
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10442 Issued in NC
Practice address
9550 Rocky River Rd Ste 202
Charlotte, NC 28215-9526
Phone
(704) 496-9001
NPI assigned
Mar 3, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 10442 NC Primary

Addresses

Primary practice location

9550 Rocky River Rd Ste 202
Charlotte, NC 28215-9526

Mailing address

9550 Rocky River Rd Ste 202
Charlotte, NC 28215-9592
Phone (704) 496-9001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160819001378 NC Order and Referring Only - DentistPractitioner - Dentist 7719272434

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
McNeely and Mallette DDS PA Dentist CurrentSince Jul 21, 2024 Accepting new patients
Kyle Viloria DMD PLLC Dentist CurrentSince Jun 9, 2024 Accepting new patients
Brian K. McNeely, DDS, PA Dentist PastSince Oct 2, 2022 Accepting new patients

Locations

9550 Rocky River Rd
Ste 202
Charlotte, NC 28215
Phone (704) 496-9001

5346 Docia Crossing Rd
Ste C
Charlotte, NC 28269
Phone (980) 275-5445

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1456963200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1346600376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9550 ROCKY RIVER RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282159592",
            "telephone_number": "704-496-9001",
            "fax_number": "855-254-9601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9550 ROCKY RIVER RD STE 202",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282159526",
            "telephone_number": "704-496-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILORIA",
        "first_name": "KYLE LESTER",
        "middle_name": "PABUSTAN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-03",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.