Kyle Blair

Primary specialty

DentistTaxonomy code 122300000X

License

DE60170682 Issued in WA

Legal business name

KYLE BLAIR

Practice address

17121 SE 270TH PL Ste 202
Covington, WA 98042-5431

Phone

(253) 630-5500

NPI assigned

Jul 20, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Klye S Blair, DDS

Title

Doctor

Phone

(253) 630-5500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Covington Family Dental Clinic Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kyle Scott Blair, D.D.S.

  • Dentist
  • Covington, WA
  • NPI 1245546068
  NPD (past)

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

{
    "created_epoch": "1468972800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1468972800000",
    "number": "1346693892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17121 SE 270TH PL STE 202",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425431",
            "telephone_number": "253-630-5500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17121 SE 270TH PL STE 202",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980425431",
            "telephone_number": "253-630-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KYLE BLAIR",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-20",
        "last_updated": "2016-07-20",
        "status": "A",
        "authorized_official_last_name": "BLAIR",
        "authorized_official_first_name": "KLYE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "DOCTOR",
        "authorized_official_telephone_number": "253-630-5500",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60170682",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1245546068",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covington Family Dental Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joann Marie Kovaly, LMT
• Kevin Scott Krall, PT
• Becca Renee Krantz, LMT
• Timothy Kranz, DPT
• Kevin Kunde, PA-C
• Theresa Landon
• Julie Anne Lang
• Nhu Thuy Lan Le, RPH
• Daniel Lee, DDS
• Sarah Kyungen Lee, RDH

• Dentist in Covington, WA
• Providers in Covington, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2016; 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.