Brandon L Taylor, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D3609 Issued in ID

Practice address

3271 N Milwaukee St
Suite 3
Boise, ID 83704-4425

Phone

(208) 658-0859

Fax

(208) 658-0893

NPI assigned

Mar 16, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in ID

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Taylor Family Dentistry

  • General Practice Dentistry
  • Boise, ID
  • NPI 1700048204
  NPD (past) Authorized official

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691452800000",
    "number": "1760451306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3271 N MILWAUKEE",
            "address_2": "SUITE 3",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "83704",
            "telephone_number": "208-658-0859",
            "fax_number": "208-658-0893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3271 N MILWAUKEE ST",
            "address_2": "SUITE 3",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837044425",
            "telephone_number": "208-658-0859",
            "fax_number": "208-658-0893"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAYLOR",
        "first_name": "BRANDON",
        "middle_name": "L",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-16",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ID",
            "license": "D3609",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROV. #",
            "identifier": "1428313",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "206330700",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Lynn Tate, PA-C
• Rachael Tatko
• Ethan Alexander Taub, D.O.
• Taylor Family Dentistry
• Benedict James Winston Taylor, MD
• Brian W Taylor
• Dylan Taylor, P-PRC
• Ekaterina Alex Taylor, FNP-C
• Eric Anthony Taylor, ATC
• Everett Anthony Taylor

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.