Provider Demographics
NPI:1013678945
Name:PAEK, TAYLOR (DMD)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:PAEK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 MCGUINNESS BLVD APT 6B
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11222-7852
Mailing Address - Country:US
Mailing Address - Phone:410-979-7535
Mailing Address - Fax:
Practice Address - Street 1:101 LAFAYETTE ST FL 6F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4153
Practice Address - Country:US
Practice Address - Phone:212-226-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-03
Last Update Date:2023-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0636771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics