Kyle Robert Michelsen, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

T-7317 Issued in OK

Practice address

2750 NW 23Rd St
Oklahoma City, OK 73107-2212

Phone

(405) 942-4445

NPI assigned

Jun 8, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Excel Dentistry and Braces

  • Dental Clinic/Center
  • Oklahoma City, OK
  • NPI 1063992121
  NPD
• Excel Dental PLLC

  • Dentist
  • Oklahoma City, OK
  • NPI 1194949586
  NPD (past)

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

{
    "created_epoch": "1591574400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591574400000",
    "number": "1811512676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 NW 86TH ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731323234",
            "telephone_number": "405-697-8695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 NW 23RD ST",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731072212",
            "telephone_number": "405-942-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELSEN",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-08",
        "last_updated": "2020-06-08",
        "certification_date": "2020-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OK",
            "license": "T-7317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Lynn Michaels
• Michelle Rayburn, LCSW, PLLC
• Michelle Vernon, PLLC
• Mark Edsall Michels, MD
• Katelyn Ann Michelsen
• Emily Michie
• Diamond Mickey
• Theodore Arthur Mickle Jr., DO, MPH
• Holly Mickley, PTA
• Mid-del Vision Source PLLC

• General Practice Dentistry in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• General Practice Dentistry in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; 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.