NPIMap

Organization Active NPI

East Taylor Dental PC

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1720181852
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
EAST TAYLOR DENTAL PC
Practice address
2201 Taylor Road
Montgomery, AL 36117-3498
Phone
(334) 271-4600
Fax
(334) 271-4709
NPI assigned
Sep 6, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Killian Joseph Horner, DDSNPI 1124132139
Title
Owner/President
Phone
(334) 271-4600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

2201 Taylor Road
Montgomery, AL 36117-3498

Mailing address

2201 Taylor Road
Montgomery, AL 36117-3498
Phone (334) 271-4600

Other identifiers 2

IdentifierTypeStateIssuer
816933OtherUNITED CONCORDIA
90188OtherALBCBS

Other names 1

  • EASTDALE DENTAL GROUP PC Former legal business name

National Provider Directory

National Provider Directory

Locations

2201 Taylor Rd
Montgomery, AL 36117
Phone (334) 271-4600

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1157500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1720181852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2201 TAYLOR ROAD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173498",
            "telephone_number": "334-271-4600",
            "fax_number": "334-271-4709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2201 TAYLOR ROAD",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361173498",
            "telephone_number": "334-271-4600",
            "fax_number": "334-271-4709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST TAYLOR DENTAL PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HORNER",
        "authorized_official_first_name": "KILLIAN",
        "authorized_official_middle_name": "JOSEPH",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "334-271-4600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "816933",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90188",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "EASTDALE DENTAL GROUP PC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.