Provider Demographics
NPI:1740631043
Name:TAYLOR, RYAN DEAN (DMD)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:DEAN
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 S 18TH ST
Mailing Address - Street 2:SUITE Q
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66102-5635
Mailing Address - Country:US
Mailing Address - Phone:913-333-5085
Mailing Address - Fax:913-333-5084
Practice Address - Street 1:151 S 18TH ST
Practice Address - Street 2:SUITE Q
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-5635
Practice Address - Country:US
Practice Address - Phone:913-333-5085
Practice Address - Fax:913-333-5084
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS61237122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist