Provider Demographics
NPI:1952998312
Name:WHITE, TAYLOR M (RDH)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:M
Last Name:WHITE
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 W 81ST ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2325
Mailing Address - Country:US
Mailing Address - Phone:816-519-4013
Mailing Address - Fax:
Practice Address - Street 1:6299 NALL AVE STE 300
Practice Address - Street 2:
Practice Address - City:MISSION
Practice Address - State:KS
Practice Address - Zip Code:66202-3551
Practice Address - Country:US
Practice Address - Phone:913-334-0044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2015018809124Q00000X
KS12030124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist