Individual provider Active NPI

John King Taylor III, DDS

  • Dentist
  • Baltimore, MD
National Provider Identifier
1376618462
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6453 Issued in MD
Practice address
1023 N Charles Street
Suite R3L
Baltimore, MD 21201
Phone
(410) 347-2995
Fax
(410) 659-1996
NPI assigned
Nov 22, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 6453 MD Primary

Addresses

Primary practice location

1023 N Charles Street
Suite R3L
Baltimore, MD 21201

Mailing address

1023 N Charles Street
Suite R3L
Baltimore, MD 21201
Phone (410) 347-2995

Other practice location 1

1 E Chase St Ste R3L
Baltimore, MD 21202-2526
Phone (443) 438-6890

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160111002151 MD Order and Referring Only - DentistPractitioner - Dentist 2264592245

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
06453MDMDClinical Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Baltimore Sleeps Better LLC Dentist CurrentSince Sep 2, 2021 Accepting new patients
Sleep Impressions, LLC Dentist Past Accepting new patients
Johns Hopkins University Dentist Past Accepting new patients
St. Francis Neighborhood Corp. General Practice Past Accepting new patients

Locations

1 E Chase St
Ste 5
Baltimore, MD 21202

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1376618462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 N CHARLES STREET",
            "address_2": "SUITE R3L",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-347-2995",
            "fax_number": "410-659-1996"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 N CHARLES STREET",
            "address_2": "SUITE R3L",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21201",
            "telephone_number": "410-347-2995",
            "fax_number": "410-659-1996"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 E Chase St Ste R3L",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212022526",
            "country_code": "US",
            "telephone_number": "443-438-6890",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JOHN",
        "middle_name": "KING",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-22",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "6453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.