Provider Demographics
NPI:1255693891
Name:KING, TAYLOR JUSTICE (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:JUSTICE
Last Name:KING
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 1:1511 ROBINSON RD
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2811
Mailing Address - Country:US
Mailing Address - Phone:615-847-8111
Mailing Address - Fax:615-847-8167
Practice Address - Street 1:1511 ROBINSON RD
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-2811
Practice Address - Country:US
Practice Address - Phone:615-847-8111
Practice Address - Fax:615-847-8167
Is Sole Proprietor?:No
Enumeration Date:2012-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9469122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist