Healthcare Provider Details

I. General information

NPI: 1366285942
Provider Name (Legal Business Name): TAYLOR GINSBERG DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2024
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4145 N 108TH AVE
PHOENIX AZ
85037-5463
US

IV. Provider business mailing address

1171 E BROADWING LN APT A303
COTTONWOOD HEIGHTS UT
84121-7627
US

V. Phone/Fax

Practice location:
  • Phone: 623-344-2000
  • Fax:
Mailing address:
  • Phone: 954-770-6113
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD012897
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: