Provider Demographics
NPI:1336529643
Name:MERKLEIN, TAYLOR (DDS)
Entity Type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:
Last Name:MERKLEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:ATCHISON
Mailing Address - State:KS
Mailing Address - Zip Code:66002-2406
Mailing Address - Country:US
Mailing Address - Phone:913-367-0212
Mailing Address - Fax:913-367-0245
Practice Address - Street 1:111 N 5TH ST
Practice Address - Street 2:
Practice Address - City:ATCHISON
Practice Address - State:KS
Practice Address - Zip Code:66002-2406
Practice Address - Country:US
Practice Address - Phone:913-367-0212
Practice Address - Fax:913-367-0245
Is Sole Proprietor?:No
Enumeration Date:2015-06-02
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61166122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist