Provider Demographics
NPI:1760868632
Name:HANSON, KYLE (DDS)
Entity type:Individual
Prefix:
First Name:KYLE
Middle Name:
Last Name:HANSON
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 1:101 W 37TH ST STE 110
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57105-5733
Mailing Address - Country:US
Mailing Address - Phone:605-339-3222
Mailing Address - Fax:
Practice Address - Street 1:101 W 37TH ST STE 110
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-5733
Practice Address - Country:US
Practice Address - Phone:605-339-3222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-03
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD1374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist