1710021167 NPI number — DR. RHNEA C TAYLOR DMD

Table of content: DR. RHNEA C TAYLOR DMD (NPI 1710021167)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710021167 NPI number — DR. RHNEA C TAYLOR DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR
Provider First Name:
RHNEA
Provider Middle Name:
C
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710021167
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/13/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 E 11TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWPORT
Provider Business Mailing Address State Name:
KY
Provider Business Mailing Address Postal Code:
41071-2203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-655-6100
Provider Business Mailing Address Fax Number:
859-342-5030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7607 DIXIE HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLORENCE
Provider Business Practice Location Address State Name:
KY
Provider Business Practice Location Address Postal Code:
41042-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
502-484-2595
Provider Business Practice Location Address Fax Number:
859-342-5030
Provider Enumeration Date:
02/19/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  6876 , registered in the state of KY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 35-2166658 . This is a "FIN" identifier , issued by the state of ( KY ) . This identifiers is of the category "OTHER".




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