Active NPI
Brett Hunter Taylor, D.D.S.
- General Practice Dentistry
- Omaha, NE
National Provider Identifier
1184755845
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6640
- Practice address
- 17455 Manderson St
Omaha, NE 68116-1159 - Phone
- (402) 333-0274
- Fax
- (402) 498-2997
- NPI assigned
- Mar 7, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6640 | NE | Primary |
Addresses
Primary practice location
17455 Manderson St
Omaha, NE 68116-1159
Mailing address
17455 Manderson Street
Omaha, NE 68116-1159
Phone (402) 333-0274
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5834 | Other | NE | BLUE CROSS & BLUE SHIELD |
| 10025448800 | Medicaid | NE |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6640 | NE | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Taylor Dentistry PLLC | General Practice | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674691200000",
"number": "1184755845",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17455 MANDERSON STREET",
"city": "OMAHA",
"state": "NE",
"postal_code": "681161159",
"telephone_number": "402-333-0274",
"fax_number": "402-498-2997"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17455 MANDERSON ST",
"city": "OMAHA",
"state": "NE",
"postal_code": "681161159",
"telephone_number": "402-333-0274",
"fax_number": "402-498-2997"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "BRETT",
"middle_name": "HUNTER",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-07",
"last_updated": "2023-01-26",
"certification_date": "2023-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "6640",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS & BLUE SHIELD",
"identifier": "5834",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025448800",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.