Taylor Reynolds Welborn, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4229-21 Issued in MS

Practice address

3223 Audubon Dr
Laurel, MS 39440-1422

Phone

(601) 651-6790

NPI assigned

Jul 13, 2021

Last updated

Jul 13, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626134400000",
    "number": "1871165563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3223 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401422",
            "telephone_number": "601-651-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3223 AUDUBON DR",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394401422",
            "telephone_number": "601-651-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELBORN",
        "first_name": "TAYLOR",
        "middle_name": "REYNOLDS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2021-07-13",
        "certification_date": "2021-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "4229-21",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "drtaylorwelborn@aspiredentalpractice.com",
            "affiliation": "Y",
            "affiliationName": "Prosper Dental Health, PLLC",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "3223 Audubon Dr",
            "city": "Laurel",
            "state": "MS",
            "country_code": "US",
            "postal_code": "394401422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Norrapol Wattanasuwan, MD
• Martha Laurie Watts, RD
• Shannon Creel Weathers, FNP-C
• Khaleah Alexandria Weathersby
• Micah Roger Welborn, C.R.N.A
• Donald Welch
• Elizabeth Danielle Welch, NP
• Wells Discount Drugs Inc (Wells Pharmacy)
• William H Wells, RPH
• Westridge Family Clinic

• General Practice Dentistry in Laurel, MS
• Providers in Laurel, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2021; 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.