MEDICARE: TAYLOR ROGERS 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	1223G0001X	General Practice Dentistry	4551	AR
2	1223G0001X	General Practice Dentistry	62416	KS
3	1223G0001X	General Practice Dentistry	2022019220	MO

General Provider Information

NPI Number	:	1164001533
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAYLOR ROGERS DDS

Provider Business Mailing Address
First Line	:	9000 STATE AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1533
Country	:	US
Telephone Number	:	870-549-1065
Fax Number	:

Provider Business Practice Location Address
First Line	:	9000 STATE AVE
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66112-1533
Country	:	US
Telephone Number	:	870-549-1065
Fax Number	:

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

Provider Enumeration Date	:	04/05/2021
Last Update Date	:	01/06/2026

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