Individual provider Active NPI

Bethany Noel Taylor, D.D.S.

  • Dentist
  • Bowling Green, OH
National Provider Identifier
1306399688
Registry record updated Aug 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.24843 Issued in OH
Practice address
1111 S Main St Ste 330
Bowling Green, OH 43402-4747
Phone
(419) 419-0779
NPI assigned
Aug 3, 2016
Last updated
Aug 3, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.24843 OH Primary

Addresses

Primary practice location

1111 S Main St Ste 330
Bowling Green, OH 43402-4747

Mailing address

1111 S Main St Ste 330
Bowling Green, OH 43402-4747
Phone (419) 419-0779

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160906000964 OH Order and Referring Only - General PracticePractitioner - General Practice 1951697713

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.24843OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1470182400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470182400000",
    "number": "1306399688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 S MAIN ST STE 330",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024747",
            "telephone_number": "419-419-0779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 S MAIN ST STE 330",
            "city": "BOWLING GREEN",
            "state": "OH",
            "postal_code": "434024747",
            "telephone_number": "419-419-0779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BETHANY",
        "middle_name": "NOEL",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-03",
        "last_updated": "2016-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.24843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, OH

Sources for this page

Verify at the official NPI Registry.