Matthew B Taylor

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

061919 Issued in NY

Practice address

213 Hallock Rd Ste 4a
Stony Brook, NY 11790-3000

Phone

(631) 762-9910

NPI assigned

Mar 7, 2019

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1551916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632441600000",
    "number": "1093273070",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "131 DERBY ST",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811836",
            "telephone_number": "718-839-0092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 HALLOCK RD STE 4A",
            "city": "STONY BROOK",
            "state": "NY",
            "postal_code": "117903000",
            "telephone_number": "631-762-9910"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "27005 76th Ave",
            "address_purpose": "LOCATION",
            "city": "New Hyde Park",
            "state": "NY",
            "postal_code": "110401402",
            "country_code": "US",
            "telephone_number": "718-470-3076",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3237 NY-112 bldg 6",
            "address_2": "Suite 7b",
            "address_purpose": "LOCATION",
            "city": "Medford",
            "state": "NY",
            "postal_code": "11763",
            "country_code": "US",
            "telephone_number": "631-320-0880",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-03-07",
        "last_updated": "2021-09-24",
        "certification_date": "2021-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "061919",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erin V Taveras, RPA-C
• Felix Bernard Tavernier, M.D.
• Suzanne Marie Tawch, DO
• George-Abraam Nasser Tawfik, MD
• James Roy Taylor Jr., M.D.
• Stephanie Teachout, MBBS
• Techmed Distributors LLC
• Lauren Telesca, MD
• Michelle M Tepper, NP
• Laura Ter Poorten, LMHC

• Pediatric Dentistry in Stony Brook, NY
• Providers in Stony Brook, NY by specialty
• Pediatric Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.