Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Kayla Lane-Illescas, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1790575769

Dr. Kayla Lane-Illescas, DDS is a Student in an Organized Health Care Education/Training Program in Princess Anne, Maryland. Licensed in Maryland. Registered with an NPI since 2025.

Licensed in
MD
In the registry since
2025
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

12165 Elm St
Princess Anne, MD 21853-1358
Phone: (410) 651-5151
Fax: (410) 651-4256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence 18809 (MD)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X (MD)

Record details

NPI number1790575769
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 12, 2025
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

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