Individual provider Active NPI

Taylor Oreilly, DDS

  • General Practice Dentistry
  • Berkeley, CA
National Provider Identifier
1043042344
Registry record updated Aug 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
110550 Issued in CA
Practice address
1860 Alcatraz Ave
Berkeley, CA 94703-2715
Phone
(510) 653-8500
NPI assigned
Aug 15, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 110550 CA Primary

Addresses

Primary practice location

1860 Alcatraz Ave
Berkeley, CA 94703-2715

Mailing address

1860 Alcatraz Ave
Berkeley, CA 94703-2715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20241029001169 CA Order and Referring Only - DentistPractitioner - Dentist 4385177419

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
110550CAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Lifelong Medical Care General Practice PastSince Aug 18, 2024 Accepting new patients
Lifelong Medical Care PastSince Aug 18, 2024 Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1723680000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723680000000",
    "number": "1043042344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1860 ALCATRAZ AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1860 ALCATRAZ AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947032715",
            "telephone_number": "510-653-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OREILLY",
        "first_name": "TAYLOR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-15",
        "last_updated": "2024-08-15",
        "certification_date": "2024-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "110550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Berkeley, CA

Sources for this page

Verify at the official NPI Registry.