Healthcare Provider Details

I. General information

NPI: 1497698500
Provider Name (Legal Business Name): TAYLOR STEELE
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2026
Last Update Date: 06/09/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9270 WICKER AVE STE E&F
SAINT JOHN IN
46373-8508
US

IV. Provider business mailing address

3022 LINCOLN ST
HIGHLAND IN
46322-2140
US

V. Phone/Fax

Practice location:
  • Phone: 219-627-3133
  • Fax:
Mailing address:
  • Phone: 219-308-5938
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12015043A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: