Kyle Trevor Malstrom, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

51158 Issued in NC

Practice address

316 County Services Park
Sylva, NC 28779-5713

Phone

(828) 586-1200

NPI assigned

Aug 15, 2017

Last updated

Aug 15, 2017By the provider in NPPES

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 NY

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

Specialty

Dentist

Education

Other, 2017

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

• New York City Health and Hospitals Corporation

  dba Gouverneur Healthcare Services

  • Clinic/Center
  • New York, NY
  • NPI 1548208127
  Medicare reassignment

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

{
    "created_epoch": "1502755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502755200000",
    "number": "1437675048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7282 WINBERT DR",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201456",
            "telephone_number": "716-462-8688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "316 COUNTY SERVICES PARK",
            "city": "SYLVA",
            "state": "NC",
            "postal_code": "287795713",
            "telephone_number": "828-586-1200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALSTROM",
        "first_name": "KYLE",
        "middle_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-15",
        "last_updated": "2017-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "51158",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlie C Lytle, MSCCCSLP
• Abigail Catherine Mace
• Daniel J Mackey, MD
• Macon Citizens for the Handicapped, Inc (Smoky ICF-MR Group Home)
• Margaret Spencer Macrae, CNM
• Robert Keith Manga, DMD
• Rebecca Elizabeth Manring, NP-C
• Lauren Jenelle March, PSY.D.
• Jerome M Marchuk, MD
• Christina M Marko, LCSWA

• Dentist in Sylva, NC
• Providers in Sylva, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2017; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.