Individual provider Active NPI

Paula A Taylor, DDS

  • Dentist
  • Commerce Township, MI
National Provider Identifier
1689786980
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901016758 Issued in MI
Practice address
39890 W 14 Mile Rd
Commerce Township, MI 48390-3911
Phone
(248) 624-8090
NPI assigned
Aug 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901016758 MI Primary
General Practice Dentistry 1223G0001X 2901016758 MI

Addresses

Primary practice location

39890 W 14 Mile Rd
Commerce Township, MI 48390-3911

Mailing address

626 N Crooks Rd
Clawson, MI 48017-1310
Phone (248) 435-9215

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160125001548 MI Order and Referring Only - DentistPractitioner - Dentist 3971806902

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901016758MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Lifetime Dental Care of Michigan, P.C. General Practice CurrentSince Jan 12, 2025 Accepting new patients
Stephen E Jacobson DDS PC General Practice PastSince Oct 23, 2022 Accepting new patients

Locations

39890 W 14 Mile Rd
Commerce Township, MI 48390
Phone (248) 624-8090

Organizations & group practices 2

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": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1689786980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "626 N CROOKS RD",
            "city": "CLAWSON",
            "state": "MI",
            "postal_code": "480171310",
            "telephone_number": "248-435-9215",
            "fax_number": "248-435-6322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39890 W 14 MILE RD",
            "city": "COMMERCE TOWNSHIP",
            "state": "MI",
            "postal_code": "483903911",
            "telephone_number": "248-624-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "PAULA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901016758",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901016758",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce Township, MI

Sources for this page

Verify at the official NPI Registry.