Taylor Addison, D.D.S

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN122969 Issued in GA

Practice address

1039 Grant St SE Ste B11
Atlanta, GA 30315-2050

Phone

(704) 747-7888

NPI assigned

Feb 5, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Bayou Smiles of Lafayette

  • Dental Clinic/Center
  • Lafayette, LA
  • NPI 1598432650
  NPD

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

{
    "created_epoch": "1612483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1154913697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 ADMIRALTY CT",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701314700",
            "telephone_number": "504-756-4581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1039 GRANT ST SE STE B11",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303152050",
            "telephone_number": "704-747-7888"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5036 Yale St Ste 302",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "700063980",
            "country_code": "US",
            "telephone_number": "504-455-2213",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10833 Le Conte Ave Rm 20-137",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900953075",
            "country_code": "US",
            "telephone_number": "310-825-5619",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1678 Mulkey Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Austell",
            "state": "GA",
            "postal_code": "301061147",
            "country_code": "US",
            "telephone_number": "770-692-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3259 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705067215",
            "country_code": "US",
            "telephone_number": "337-367-1271",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ADDISON",
        "first_name": "TAYLOR",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-02-05",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7153",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "LA",
            "license": "7153",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "DN122969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kateena Addae-Konadu, M.D., PH.D.
• Kristin Alexis Adderley, MD
• Addies Tender Home Care Services
• Andrea Addington, RD, LD
• Joshua Addison
• Whitney Addison
• Addys Cabanas PC
• Monsurat Modpe Adebayo, NP
• Rasaki Adebisi, PAAA
• Aderonke Adeboye, PHARMD

• Pediatric Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.