Provider Demographics
NPI:1023688124
Name:LADD, TAYLOR AUSTIN (DDS)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:AUSTIN
Last Name:LADD
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 1:2032 N KING ST
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96819-3458
Mailing Address - Country:US
Mailing Address - Phone:575-312-6373
Mailing Address - Fax:
Practice Address - Street 1:2032 N KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-3458
Practice Address - Country:US
Practice Address - Phone:575-312-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2025-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002060891223G0001X
NMDD54641223G0001X
HIDT-31631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMDD5464OtherNM DENTAL LICENSE NUMBER
HIDT-3163OtherHI DENTAL LICENSE NUMBER