Usitalo, Taylor L
Usitalo, Taylor L is an individual health care provider with primary practice located at 2027 Cerrillos Rd , Santa Fe NM 87505-3269. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Usitalo, Taylor L can be contacted via phone (505) 820-1212.Contact Information
Primary practice address
2027 Cerrillos Rd
Santa Fe NM 87505-3269
Phone: (505) 820-1212
Fax: (505) 820-1218
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DD0000 | New Mexico |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DD0000 | New Mexico |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | DD4663 | New Mexico |
Profile Details
| NPI number | 1962934612 |
|---|---|
| LBN Legal business name | Usitalo, Taylor L |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 31st, 2017 |
| Last updated | Jul 19th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962934612 | NPPES |
| New Mexico | MEDICAID | 90050843 |
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