Active NPI
Lisa Marie Taylor, RDH
- Dental Hygienist
- Kenosha, WI
National Provider Identifier
1487396628
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 1003804-16
- Practice address
- 6226 14TH Ave
Kenosha, WI 53143-4413 - Phone
- (262) 656-0044
- NPI assigned
- Apr 8, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 1003804-16 | WI | Primary |
Addresses
Primary practice location
6226 14TH Ave
Kenosha, WI 53143-4413
Mailing address
2123 89TH PL
Kenosha, WI 53143-6705
Phone (706) 273-1365
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1003804-16 | WI | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649376000000",
"number": "1487396628",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2123 89TH PL",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531436705",
"telephone_number": "706-273-1365"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6226 14TH AVE",
"city": "KENOSHA",
"state": "WI",
"postal_code": "531434413",
"telephone_number": "262-656-0044"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "LISA",
"middle_name": "MARIE",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-04-08",
"last_updated": "2022-04-08",
"certification_date": "2022-04-04",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WI",
"license": "1003804-16",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kenosha, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.