Jennifer Lynn Taylor, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010849A Issued in IN

Practice address

7524 S Anthony Blvd
Fort Wayne, IN 46816-2517

Phone

(260) 441-8500

NPI assigned

Oct 12, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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 and National Provider Directory roles.

• Clute Youth Dentistry, Inc.

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1679988588
  NPD (past)
• Wayne Youth Dentistry, LLC

  • General Practice Dentistry
  • Fort Wayne, IN
  • NPI 1356399182
  NPD (past)

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1553040000000",
    "number": "1124117718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7524 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162523",
            "telephone_number": "260-441-8500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7524 S ANTHONY BLVD",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468162517",
            "telephone_number": "260-441-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JENNIFER",
        "middle_name": "LYNN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-12",
        "last_updated": "2019-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010849A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201238440A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ethel Ann Taylor, DPT
• George D Taylor, OD
• Gwen Rene Taylor, COTA
• Hannah Anne Taylor, DO
• Jaquell Rena Taylor
• Kamaria Taylor
• Kristine Taylor
• Lavina Taylor, RBT
• Lynn Marie Taylor, MS LCSW LMFT
• Marie C. Taylor, MS, LMFT

• General Practice Dentistry in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.