Russell Demetrius Taylor III, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

35703 Issued in TX

Practice address

1515 N Town East Blvd Ste 215
Mesquite, TX 75150-4144

Phone

(972) 686-1955

NPI assigned

May 3, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1336003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644883200000",
    "number": "1124387683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 UPTOWN BLVD STE 3100",
            "city": "CEDAR HILL",
            "state": "TX",
            "postal_code": "751043535",
            "telephone_number": "910-551-8020"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 N TOWN EAST BLVD STE 215",
            "city": "MESQUITE",
            "state": "TX",
            "postal_code": "751504144",
            "telephone_number": "972-686-1955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "RUSSELL",
        "middle_name": "DEMETRIUS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-03",
        "last_updated": "2022-02-15",
        "certification_date": "2022-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "81236609921",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "35703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nada Tariq, MS
• Brittney T Tatum, LPC
• Ashlyn Taylor
• Kenneth Wayne Taylor, DDS
• Misty L Taylor, FNP
• William F Taylor III, ATC, LAT
• Sudha Teerdhala, MD
• Yasmin Pyarali Tejani, D.O.
• Hassenet Teklu
• Terrell Dialysis Center, LLC

• Endodontics in Mesquite, TX
• Providers in Mesquite, TX by specialty
• Endodontics in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2022; 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.