Michael Martin Taylor, DDS, MSD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

1725 Issued in NM

Practice address

200 W Wilshire Blvd Ste E
Roswell, NM 88201-0627

Phone

(505) 622-4369

Fax

(505) 622-8557

NPI assigned

Dec 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376606350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 W WILSHIRE BLVD STE E",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010627",
            "telephone_number": "505-622-4369",
            "fax_number": "505-622-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W WILSHIRE BLVD STE E",
            "city": "ROSWELL",
            "state": "NM",
            "postal_code": "882010627",
            "telephone_number": "505-622-4369",
            "fax_number": "505-622-8557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "MICHAEL",
        "middle_name": "MARTIN",
        "name_prefix": "Dr.",
        "credential": "DDS, MSD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NM",
            "license": "1725",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00082879",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Ralph Tellez, MA
• Katherine M Thatcher, CNP
• The Peak at Santa Teresa, Inc. (The Peak Treatment Foster Care)
• The Smiling Lotus, LLC (The Smiling Lotus Counseling and Consultation)

• Orthodontics and Dentofacial Orthopedics Dentistry in Roswell, NM
• Providers in Roswell, NM by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.