DR. RUSSELL DEMETRIUS TAYLOR III (NPI# 1124387683) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124387683 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL DEMETRIUS TAYLOR III |
| Credential | DDS |
| Practice Address |
4323 Hill Street Us Army Dental Activity Fort Jackson SC 29207-6022 |
| Practice Telephone | 8037516213 |
| Mailing Telephone | 8037516213 |
| Enumeration Date | 2012-05-03 |
| Last Update Date | 2012-05-03 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
81236609921 | UT | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891006706 | Russell Kaleo Taylor | Anesthesiology | 317 New London Cmn, Santa Ana, CA 92704-1257 | 2010-06-24 |
| 1083787931 | Russell Scott Taylor | Dentist | 534 A Wythe Creek Road, Poquoson, VA 23662 | 2006-11-16 |
| 1821074162 | Russell J Taylor | Urology | 770 West High Street, Suite 350, Lima, OH 45801-5901 | 2005-12-19 |
| 1477982635 | Russell Haywood Taylor | Dentist | 260 Stockton St, 5th Floor, San Francisco, CA 94108-5305 | 2013-11-07 |
| 1376873125 | Russell B. Taylor | Chiropractor | 1760 N Main St, Suite 103, Cedar City, UT 84721-7775 | 2009-12-29 |
| 1467593871 | Russell J Taylor | Dentist | 103 Old Marlton Pike, Suite 200, Medford, NJ 08055-8772 | 2007-02-09 |
| 1669532214 | Russell Todd Taylor | Dentist | 4210 N 32nd St, Phoenix, AZ 85018-4723 | 2006-12-12 |
| 1942218219 | Russell Guy Taylor | Psychologist | 557 N Westgate Ave, Jacksonville, IL 62650-1156 | 2006-08-03 |
| Street Address |
4323 HILL STREET US ARMY DENTAL ACTIVITY |
| City | FORT JACKSON |
| State | SC |
| Zip Code | 29207-6022 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699221275 | Corey Carroll | Dentist | 4323 Hill Street, Fort Jackson, SC 29207 | 2016-09-01 |
| 1750730347 | Stephanie Hadden | Dental Hygienist | 4323 Hill Street, Usa Dentac, Fort Jackson, SC 29207 | 2016-06-06 |
| 1821424185 | James L Koehler Jr. | Dentist | 4323 Hill Street, Us Army Dental Activity, Fort Jackson, SC 29207-6022 | 2013-09-18 |
| 1538509500 | Mitchell Eli Becker | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-07-05 |
| 1093152670 | Drew D Farmer | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-05-23 |
| 1932543121 | Erick Jordan Lund | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-04-18 |
| 1770842239 | Migdalia Torres | Dentist | 4323 Hill Street, Us Army Dental Activity, Fort Jackson, SC 29207-6022 | 2012-05-03 |
| 1255690707 | Mohamad El Samad | Dentist | 4323 Hill Street, Us Army Dental Activity, Fort Jackson, SC 29207-6022 | 2012-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265043756 | Steven Mariani Rodriguez | Dentist | 5330 Moseby Street, Columbia, SC 29207 | 2020-08-10 |
| 1568082493 | Nichole Eckrich | Dentist | 5330 Moseby St., Columbia, SC 29207 | 2020-04-21 |
| 1730733007 | Forrest Wane Fullenkamp | Student in an Organized Health Care Education/Training Program | 5330 Moseby St, Columbia, SC 29207 | 2019-07-25 |
| 1306401625 | Kayla Anne Wolcott | Pharmacist | Moncrief Army Hospital Outpatient Pharmacy 1 Ft Jackson, Columbia, SC 29207 | 2019-05-02 |
| 1588145098 | Renetta Denise Green | Counselor | Fort Jackson/acs 9810 Lee St, Columbia, SC 29207 | 2018-08-23 |
| 1154814028 | Amanda Zelnick | Dentist | Bldg 5330 Moseby St, Ft Jackson, NC 29207 | 2018-06-14 |
| 1790231777 | Brittaney Elizabeth Anne Lewelling | Specialist/Technologist | 5975 Chesnut Road, Columbia, SC 29207 | 2016-08-30 |
| 1376749838 | Moncrief Army Community Hospital | Clinic/Center | 5330 Mosby Street, Fort Jackson, SC 29207 | 2007-06-22 |
| 1902002462 | Moncrief Army Community Hospital | Clinic/Center | 1890 Washington Road, Fort Jackson, SC 29207 | 2007-06-22 |
| 1730279860 | Donna L Briquet | Pharmacist | 4500 Marion Street, Columbia, SC 29207 | 2006-10-12 |
| Find all providers in zip 29207 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679682629 | Chrystal Regina Stephens | Dentist | 3295 Forney St., Fort Jackson, SC 29207-5780 | 2006-08-30 |
| 1710917265 | Andrew Christian Marshall | Dentist | 3295 Forney Street, Fort Jackson, SC 29207-5780 | 2006-07-03 |
| 1013991660 | Herbert Mckinney | Dentist | 4323 Hill St., Fort Jackson, SC 29207-5604 | 2005-12-06 |
| 1275517435 | James William Cartwright Jr. | Dentist | 3295 Forney St, Fort Jackson, SC 29207-5604 | 2005-12-01 |
| 1689679706 | Paul R Maco | Dentist | 4323 Hill St, Fort Jackson, SC 29207 | 2005-06-15 |
| 1821424185 | James L Koehler Jr. | Dentist | 4323 Hill Street, Us Army Dental Activity, Fort Jackson, SC 29207-6022 | 2013-09-18 |
| 1538509500 | Mitchell Eli Becker | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-07-05 |
| 1093152670 | Drew D Farmer | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-05-23 |
| 1932543121 | Erick Jordan Lund | Dentist | 4323 Hill Street, Usa Dental Activity, Fort Jackson, SC 29207-6022 | 2013-04-18 |
| 1770842239 | Migdalia Torres | Dentist | 4323 Hill Street, Us Army Dental Activity, Fort Jackson, SC 29207-6022 | 2012-05-03 |
| Find all providers in FORT JACKSON | ||||
| City | FORT JACKSON |
| Zip Code | 29207 |
Please comment or provide details below to improve the information on DR. RUSSELL DEMETRIUS TAYLOR III.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.