Individual provider Active NPI

Jacob M Taylor, DMD

  • General Practice Dentistry
  • Billings, MT
National Provider Identifier
1417185828
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2361 Issued in MT
Practice address
525 Henry Chapple St Ste 5
Billings, MT 59106-1865
Phone
(406) 652-1600
Fax
(406) 652-1205
NPI assigned
Jun 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2361 MT Primary

Addresses

Primary practice location

525 Henry Chapple St Ste 5
Billings, MT 59106-1865

Mailing address

525 Henry Chapple St Ste 5
Billings, MT 59106-1865
Phone (406) 652-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20151006001509 MT Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6305154642

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2361MTMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Granite Peak, PLLC CurrentSince Jan 14, 2024 Accepting new patients

Locations

2700 Grand Ave
Ste E
Billings, MT 59102
Phone (406) 652-1600

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704844800000",
    "number": "1417185828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "525 HENRY CHAPPLE ST STE 5",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591061865",
            "telephone_number": "406-652-1600",
            "fax_number": "406-652-1205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "525 HENRY CHAPPLE ST STE 5",
            "city": "BILLINGS",
            "state": "MT",
            "postal_code": "591061865",
            "telephone_number": "406-652-1600",
            "fax_number": "406-652-1205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "JACOB",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-24",
        "last_updated": "2024-01-10",
        "certification_date": "2023-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "2361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Billings, MT

Sources for this page

Verify at the official NPI Registry.