Provider Demographics
NPI:1386745156
Name:MARKLE, TAYLOR L (DDS)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:L
Last Name:MARKLE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18560 WEST 66TH TERRACE
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218
Mailing Address - Country:US
Mailing Address - Phone:913-268-5626
Mailing Address - Fax:
Practice Address - Street 1:1010 CARONDELET DR.
Practice Address - Street 2:SUITE 316
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114
Practice Address - Country:US
Practice Address - Phone:816-941-0000
Practice Address - Fax:816-941-3146
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO134951223S0112X
KS57641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOB056746BMedicare ID - Type Unspecified
MOT73592Medicare UPIN