Active NPI
Jeffrey A Taylor, D.D.S.
- Dentist
- Atlanta, MI
National Provider Identifier
1760500326
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 2901017257
- Practice address
- 11899 M 32
Atlanta, MI 49709-0850 - Phone
- (989) 354-2197
- Fax
- (989) 356-6524
- NPI assigned
- Mar 26, 2007
- Last updated
- Oct 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901017257 | MI | Primary |
Addresses
Primary practice location
11899 M 32
Atlanta, MI 49709-0850
Mailing address
PO Box 427
Hillman, MI 49746-0427
Phone (989) 354-2197
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150610002294 | MI | Order and Referring Only - Dentist | 3870814247 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174867200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1318464000000",
"number": "1760500326",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 427",
"city": "HILLMAN",
"state": "MI",
"postal_code": "497460427",
"telephone_number": "989-354-2197",
"fax_number": "989-356-6524"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11899 M 32",
"city": "ATLANTA",
"state": "MI",
"postal_code": "497090850",
"telephone_number": "989-354-2197",
"fax_number": "989-356-6524"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAYLOR",
"first_name": "JEFFREY",
"middle_name": "A",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-26",
"last_updated": "2011-10-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901017257",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
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Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 2011; 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.