MEDICARE: TAYLOR BAKER RDH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	124Q00000X	Dental Hygienist	2902017523	MI

General Provider Information

NPI Number	:	1689518912
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR BAKER RDH

Provider Business Mailing Address
First Line	:	5555 CONNER ST STE 110
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-3448
Country	:	US
Telephone Number	:	313-571-2648
Fax Number	:

Provider Business Practice Location Address
First Line	:	5555 CONNER ST STE 110
Second Line	:
City	:	DETROIT
State	:	MI
Zip	:	48213-3448
Country	:	US
Telephone Number	:	313-571-2648
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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Directions to “ TAYLOR BAKER RDH” Practice Location

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