Individual provider Active NPI

Kyle Orr, D.M.D.

  • Oral and Maxillofacial Surgery (Dentist)
  • Newport News, VA
National Provider Identifier
1750813937
Registry record updated Jul 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
0401417820 Issued in VA
Practice address
716 Denbigh Blvd Ste C1
Newport News, VA 23608-4414
Phone
(757) 874-6501
Fax
(757) 874-8741
NPI assigned
Mar 28, 2017
Last updated
Jul 20, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 0401417820 VA Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

716 Denbigh Blvd Ste C1
Newport News, VA 23608-4414

Mailing address

716 Denbigh Blvd Ste C1
Newport News, VA 23608-4414
Phone (757) 874-6501

Other practice location 1

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2904

Other practice location 2

1500 S Main St
Fort Worth, TX 76104-4917
Phone (817) 702-1173

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20181024003125 SC Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305199126

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401417820VAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
TDT Oms Oral and Maxillofacial Surgery CurrentSince Jul 24, 2022 Accepting new patients
Ronald Tankersley DDS Numa Ray Lee DDS Jeffrey N Kenney DDS W Les Oral and Maxillofacial Surgery PastSince Jul 24, 2022 Accepting new patients

Locations

716 Denbigh Blvd
Ste C1
Newport News, VA 23608
Phone (757) 874-6501

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1490659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658275200000",
    "number": "1750813937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 DENBIGH BLVD STE C1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084414",
            "telephone_number": "757-874-6501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "716 DENBIGH BLVD STE C1",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236084414",
            "telephone_number": "757-874-6501",
            "fax_number": "757-874-8741"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "171 Ashley Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "29425",
            "country_code": "US",
            "telephone_number": "843-792-2904",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1500 S Main St",
            "address_purpose": "LOCATION",
            "city": "Fort Worth",
            "state": "TX",
            "postal_code": "761044917",
            "country_code": "US",
            "telephone_number": "817-702-1173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ORR",
        "first_name": "KYLE",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-03-28",
        "last_updated": "2022-07-20",
        "certification_date": "2022-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "VA",
            "license": "0401417820",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport News, VA

Sources for this page

Verify at the official NPI Registry.