Individual provider Active NPI

D. Lance Taylor, D.M.D., M.S., P.C.

  • Endodontics
  • Springfield, IL
National Provider Identifier
1114935590
Registry record updated Mar 16, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
021-001693 Issued in IL
Practice address
2050 W Iles Ave Ste C
Springfield, IL 62704-4194
Phone
(217) 698-6150
Fax
(217) 698-6151
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 16, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 021-001693 IL Primary

Addresses

Primary practice location

2050 W Iles Ave Ste C
Springfield, IL 62704-4194

Mailing address

2050 W Iles Ave Ste C
Springfield, IL 62704-4194
Phone (217) 698-6150

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
021-001693ILMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268697600000",
    "number": "1114935590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2050 W ILES AVE STE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044194",
            "telephone_number": "217-698-6150",
            "fax_number": "217-698-6151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2050 W ILES AVE STE C",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044194",
            "telephone_number": "217-698-6150",
            "fax_number": "217-698-6151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "D.",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S., P.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2010-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "IL",
            "license": "021-001693",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springfield, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2010; 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.