Kelly Eldon Taylor, D.M.D

Primary specialty

ProsthodonticsTaxonomy code 1223P0700X

License

DE00008680 Issued in WA

Practice address

860 S 2ND Ave
Suite a
Walla Walla, WA 99362-4072

Phone

(509) 529-2000

Fax

(509) 529-4590

NPI assigned

May 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Taylor Dental Clinic

  • Dental Clinic/Center
  • Walla Walla, WA
  • NPI 1740574060
  NPD (past) Authorized official

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

{
    "created_epoch": "1147651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1306800000000",
    "number": "1467403253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 DONRITA CT",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993628018",
            "telephone_number": "509-593-4739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 S 2ND AVE",
            "address_2": "SUITE A",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993624072",
            "telephone_number": "509-529-2000",
            "fax_number": "509-529-4590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "KELLY",
        "middle_name": "ELDON",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-15",
        "last_updated": "2011-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "WA",
            "license": "DE00008680",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "OR",
            "license": "D8732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "171037",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tallmans Pharmacy Inc
• John Joseph Tank, LMHCA
• Londa Tataryn, P.T.
• Taylor Dental Clinic
• Anna Marie Taylor, MED, LAT, ATC
• Laura Taylor
• Teaming for Success
• Bayu Teklu, MD
• Rebekah Lynn Telfer, DPT
• Claire Templin, D.O.

• Prosthodontics in Walla Walla, WA
• Providers in Walla Walla, WA by specialty
• Prosthodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2011; 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.