Healthcare Provider Details

I. General information

NPI: 1871289447
Provider Name (Legal Business Name): TAYLOR DENISE KING MHS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 12/15/2025
Certification Date: 12/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11700 TEEL PKWY STE 301
FRISCO TX
75033-5012
US

IV. Provider business mailing address

5217 TENNYSON PKWY STE 500
PLANO TX
75024-4125
US

V. Phone/Fax

Practice location:
  • Phone: 469-850-5550
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30.027278
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number42108
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: