Provider Demographics
NPI:1417443276
Name:LANTZ, KYLE THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:KYLE
Middle Name:THOMAS
Last Name:LANTZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3744 S TIMBERLINE RD STE 101
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525-4334
Mailing Address - Country:US
Mailing Address - Phone:970-229-1404
Mailing Address - Fax:
Practice Address - Street 1:516 W EISENHOWER BLVD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537-3106
Practice Address - Country:US
Practice Address - Phone:970-232-3750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-05
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDRPM26011223E0200X
CO002062791223E0200X
NMDD4933122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist