Kayla Patricia Kolodychak, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

13107 Issued in TN

Practice address

1500 E Medical Center Dr SPC 5346
Ann Arbor, MI 48109-5346

Phone

(734) 936-8289

NPI assigned

May 8, 2025

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1746662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782086400000",
    "number": "1780474254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "551 LORD RD",
            "city": "FAIRVIEW",
            "state": "PA",
            "postal_code": "164151525",
            "telephone_number": "814-969-6576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR SPC 5346",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095346",
            "telephone_number": "734-936-8289"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "113 Harbor Town Sq Ste 203",
            "address_purpose": "LOCATION",
            "city": "Memphis",
            "state": "TN",
            "postal_code": "381038890",
            "country_code": "US",
            "telephone_number": "901-453-6081",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KOLODYCHAK",
        "first_name": "KAYLA",
        "middle_name": "PATRICIA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-05-08",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TN",
            "license": "13107",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "1780474254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Kolena
• Theodore John Kolias, MD
• Robert Jay Koliner, D.C.
• Josef N Kolling, D.D.S., M.S.
• Michaelean Kollman, MA, CCC-SLP
• Jeffrey Kolominsky, MD
• Courtney Kolp
• Marissa Kolp
• Katherine Komon
• Hannah Claire Kondolf, MD, PHD

• Dentist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 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.