Healthcare Provider Details

I. General information

NPI: 1003198664
Provider Name (Legal Business Name): TAYLOR LANDON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2011
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 N SARATOGA ST BLDG 993
OAK HARBOR WA
98278-4927
US

IV. Provider business mailing address

3475 N SARATOGA ST BLDG 993
OAK HARBOR WA
98278-4927
US

V. Phone/Fax

Practice location:
  • Phone: 360-257-2302
  • Fax:
Mailing address:
  • Phone: 360-257-2302
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number60834
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: