Provider Demographics
NPI:1427157213
Name:TAYLOR, ROBERT JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:TAYLOR
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 1:26302 LA PAZ RD
Mailing Address - Street 2:SUITE #210
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-5313
Mailing Address - Country:US
Mailing Address - Phone:949-380-0315
Mailing Address - Fax:949-380-7830
Practice Address - Street 1:26302 LA PAZ RD
Practice Address - Street 2:SUITE #210
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-5313
Practice Address - Country:US
Practice Address - Phone:949-380-0315
Practice Address - Fax:949-380-7830
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA273861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice