Provider Demographics
NPI:1982183844
Name:COOK, TAYLOR FW (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:FW
Last Name:COOK
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 1:2645 RAILROAD ST APT 122
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15222-5625
Mailing Address - Country:US
Mailing Address - Phone:515-360-9324
Mailing Address - Fax:
Practice Address - Street 1:563 EPSILON DR STE 200
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15238-2830
Practice Address - Country:US
Practice Address - Phone:412-449-0132
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-11
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN1858097122300000X
390200000X
PADS0428741223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program