Healthcare Provider Details

I. General information

NPI: 1952233124
Provider Name (Legal Business Name): TAYLOR ELIZABETH DEHAVEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2805 HIGHWAY 90 STE 1
GAUTIER MS
39553-5113
US

IV. Provider business mailing address

1208 KING HENRY DR
OCEAN SPRINGS MS
39564-3410
US

V. Phone/Fax

Practice location:
  • Phone: 228-497-2424
  • Fax:
Mailing address:
  • Phone: 540-326-5408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112707
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: