Individual provider Active NPI

Darcey Jerome Taylor, DMD

  • General Practice Dentistry
  • Lawrenceville, GA
National Provider Identifier
1609933357
Registry record updated Jan 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN010428 Issued in GA
Practice address
860 Duluth Hwy Ste 1030
Lawrenceville, GA 30043-5349
Phone
(770) 682-7380
Fax
(770) 476-5078
NPI assigned
Jan 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2023

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 DN010428 GA Primary

Addresses

Primary practice location

860 Duluth Hwy Ste 1030
Lawrenceville, GA 30043-5349

Mailing address

860 Duluth Hwy Ste 1030
Lawrenceville, GA 30043-5349
Phone (770) 682-7380

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20210629002022 GA Order and Referring Only - DentistPractitioner - Dentist 7113328055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dentfirst PC General Practice Past Accepting new patients

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": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673913600000",
    "number": "1609933357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 DULUTH HWY STE 1030",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435349",
            "telephone_number": "770-682-7380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 DULUTH HWY STE 1030",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435349",
            "telephone_number": "770-682-7380",
            "fax_number": "770-476-5078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "DARCEY",
        "middle_name": "JEROME",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2023-01-17",
        "certification_date": "2023-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN010428",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lawrenceville, GA

Sources for this page

Verify at the official NPI Registry.