MEDICARE: DR. LLOYD RICHARD TAYLOR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	C26288	CA
2	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	C26288	CA

General Provider Information

NPI Number	:	1083047898
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LLOYD RICHARD TAYLOR DDS

Provider Business Mailing Address
First Line	:	13343 SHERMAN WAY
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-4442
Country	:	US
Telephone Number	:	818-982-8984
Fax Number	:	818-982-9501

Provider Business Practice Location Address
First Line	:	13343 SHERMAN WAY
Second Line	:
City	:	NORTH HOLLYWOOD
State	:	CA
Zip	:	91605-4442
Country	:	US
Telephone Number	:	818-982-8984
Fax Number	:	818-982-9501

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	08/15/2013

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