Individual provider Active NPI

Claire Troullier, DDS

  • Dentist
  • Manitowoc, WI
National Provider Identifier
1043770266
Registry record updated Dec 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
1002154 Issued in WI
Practice address
1503 Randolph CT
Manitowoc, WI 54220-8345
Phone
(920) 860-6841
NPI assigned
Mar 22, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1002154 WI Primary

Addresses

Primary practice location

1503 Randolph CT
Manitowoc, WI 54220-8345

Mailing address

1503 Randolph CT
Manitowoc, WI 54220-8345
Phone (920) 860-6841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200716001858 WI Order and Referring Only - DentistPractitioner - Dentist 8820412307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1002154WIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Park SC PastSince Dec 10, 2023 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701648000000",
    "number": "1043770266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1503 RANDOLPH CT",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542208345",
            "telephone_number": "920-860-6841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1503 RANDOLPH CT",
            "city": "MANITOWOC",
            "state": "WI",
            "postal_code": "542208345",
            "telephone_number": "920-860-6841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROULLIER",
        "first_name": "CLAIRE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2023-12-04",
        "certification_date": "2023-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1002154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manitowoc, WI

Sources for this page

Verify at the official NPI Registry.