Active NPI
Sherwin Jerome Taylor
- Dental Hygienist
- Hawthorne, CA
National Provider Identifier
1255770343
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 25300
- Practice address
- 12730 Hawthorne Blvd Ste D
Hawthorne, CA 90250-3919 - Phone
- (310) 644-4000
- NPI assigned
- Jun 21, 2013
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 25300 | CA | Primary |
Addresses
Primary practice location
12730 Hawthorne Blvd Ste D
Hawthorne, CA 90250-3919
Mailing address
12121 Wilshire Blvd Ste 1111
Los Angeles, CA 90025-1188
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 |
|---|---|---|---|
| 25300 | CA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1371772800000",
"number": "1255770343",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12121 WILSHIRE BLVD STE 1111",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900251188"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12730 HAWTHORNE BLVD STE D",
"city": "HAWTHORNE",
"state": "CA",
"postal_code": "902503919",
"telephone_number": "310-644-4000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "SHERWIN",
"middle_name": "JEROME",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-21",
"last_updated": "2013-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "25300",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.