Individual provider Active NPI

Tayler Faircloth

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Scottsdale, AZ
National Provider Identifier
1083011316
Registry record updated Dec 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
43835 Issued in AZ
Practice address
3501 N Scottsdale Rd
226
Scottsdale, AZ 85251
Phone
(480) 941-5005
NPI assigned
Dec 2, 2014
Last updated
Dec 2, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 43835 AZ Primary

Addresses

Primary practice location

3501 N Scottsdale Rd
226
Scottsdale, AZ 85251

Mailing address

3501 N Scottsdale Rd
Scottsdale, AZ 85251
Phone (480) 941-5005

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
43835AZMDOral & Maxillofacial Surgery (D.M.D.)

Practice roles

OrganizationSpecialtyStatusNew patients
Derek H. Lamb, DMD, MD, PLLC Past Accepting new patients
Scottsdale Facial & Oral Surgery LLC PastSince Jan 19, 2020 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1417478400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417478400000",
    "number": "1083011316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85251",
            "telephone_number": "480-941-5005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 N SCOTTSDALE RD",
            "address_2": "226",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "85251",
            "telephone_number": "480-941-5005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRCLOTH",
        "first_name": "TAYLER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-02",
        "last_updated": "2014-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "AZ",
            "license": "43835",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2014; 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.