NPIMap

Organization Active NPI

Taylor Beach Club

Doing business as The Mount Pleasant Dentist

  • Dentist
  • Mount Pleasant, TX
National Provider Identifier
1720499189
Registry record updated May 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
15101 Issued in TX
Legal business name
TAYLOR BEACH CLUB
Doing business as
The Mount Pleasant Dentist
Practice address
204 W 19TH St
Mt Pleasant, TX 75455-2320
Phone
(903) 572-4141
Fax
(972) 596-9747
NPI assigned
May 19, 2014
Last updated
May 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 22, 2014

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

Authorized official

Name
Dr. Jesse Martin Taylor III, D.D.S.
Title
Sole Member
Phone
(972) 519-0990

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 15101 TX Primary

Addresses

Primary practice location

204 W 19TH St
Mt Pleasant, TX 75455-2320

Mailing address

204 W 19TH St
Mt Pleasant, TX 75455-2320
Phone (903) 572-4141

Other names 1

  • The Mount Pleasant Dentist Doing business as

National Provider Directory

National Provider Directory

Locations

204 W 19th St
Mt Pleasant, TX 75455
Phone (903) 305-8712

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1400457600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400716800000",
    "number": "1720499189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 W 19TH ST",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754552320",
            "telephone_number": "903-572-4141",
            "fax_number": "972-596-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W 19TH ST",
            "city": "MT PLEASANT",
            "state": "TX",
            "postal_code": "754552320",
            "telephone_number": "903-572-4141",
            "fax_number": "972-596-9747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAYLOR BEACH CLUB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-19",
        "last_updated": "2014-05-22",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "JESSE",
        "authorized_official_middle_name": "MARTIN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "972-519-0990",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "TX",
            "license": "15101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Mount Pleasant Dentist",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mount Pleasant, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2014; 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.