Healthcare Provider Details

I. General information

NPI: 1700680683
Provider Name (Legal Business Name): DR. TAYLOR SPRUILL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 08/29/2026
Certification Date: 08/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

149 BRAUER HALL CB 7450
CHAPEL HILL NC
27599-0001
US

IV. Provider business mailing address

9893 GEORGETOWN PIKE PO BOX #182
GREAT FALLS VA
22066-2617
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3565
  • Fax:
Mailing address:
  • Phone: 301-957-0411
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14630
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: