Amanda Tinesha Taylor, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17231 Issued in MD

Practice address

117 Saint Patricks Dr
Waldorf, MD 20603-4574

Phone

(301) 870-4553

NPI assigned

Oct 3, 2013

Last updated

Feb 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Neibauer Dental Care, PC

  dba Neibauer Dental Care. - Waldorf

  • General Practice Dentistry
  • Waldorf, MD
  • NPI 1407123045
  NPD (past)

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

{
    "created_epoch": "1380758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582329600000",
    "number": "1053748228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15046 BARNES MEADOWS CT",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933188",
            "telephone_number": "919-260-5850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 SAINT PATRICKS DR",
            "city": "WALDORF",
            "state": "MD",
            "postal_code": "206034574",
            "telephone_number": "301-870-4553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "AMANDA",
        "middle_name": "TINESHA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-03",
        "last_updated": "2020-02-22",
        "certification_date": "2020-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "29790",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401416758",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17231",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talk to Me
• Iyana Talley
• Denis Telemacus Taponju, CNA
• Ashley Elizabeth Tarjick
• Gail Francis Tarlton, MS APRN BC
• Angela Taylor
• Brian Andrew Taylor, OD
• Dean A Taylor
• Ettelle Taylor
• Tierra Alecia Taylor

• General Practice Dentistry in Waldorf, MD
• Providers in Waldorf, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.