Active NPI
Dexter Canoy
- Otorhinolaryngology & Head-Neck Registered Nurse
- Los Angeles, CA
National Provider Identifier
1104789809
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otorhinolaryngology & Head-Neck Registered Nurse
- License
- 95292177
- Practice address
- 11301 Wilshire Blvd
Los Angeles, CA 90073-1003 - Phone
- (310) 478-3711
- NPI assigned
- Dec 9, 2025
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Continuing Education/Staff Development Registered Nurse | 163WC1600X | 95292177 | CA | |
| Medical-Surgical Registered Nurse | 163WM0705X | 95292177 | CA | |
| Otorhinolaryngology & Head-Neck Registered Nurse | 163WX0601X | 95292177 | CA | Primary |
| Registered Nurse | 163W00000X | 95292177 | CA |
Addresses
Primary practice location
11301 Wilshire Blvd
Los Angeles, CA 90073-1003
Mailing address
1636 Cherry Tree PL
Upland, CA 91784-2530
Phone (626) 510-3301
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 95292177 | CA | MD | Continuing Education/Staff Development Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1765238400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1765238400000",
"number": "1104789809",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1636 CHERRY TREE PL",
"city": "UPLAND",
"state": "CA",
"postal_code": "917842530",
"telephone_number": "626-510-3301"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11301 WILSHIRE BLVD",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900731003",
"telephone_number": "310-478-3711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CANOY",
"first_name": "DEXTER",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2025-12-09",
"last_updated": "2025-12-09",
"certification_date": "2025-12-09",
"status": "A"
},
"taxonomies": [
{
"code": "163WC1600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Continuing Education/Staff Development",
"state": "CA",
"license": "95292177",
"primary": false
},
{
"code": "163WM0705X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Medical-Surgical",
"state": "CA",
"license": "95292177",
"primary": false
},
{
"code": "163WX0601X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Otorhinolaryngology & Head-Neck",
"state": "CA",
"license": "95292177",
"primary": true
},
{
"code": "163W00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse",
"state": "CA",
"license": "95292177",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Los Angeles, CA
- Luisa Fernanda Canon Garzon
- Canon Human Services Centers Inc
- Canon Human Services Centers, Inc,
- Jeffrey D Canonoy, BSN, PMHRN-BC, RN
- Sandy Beller Canout, O.T.,P.T.,C.F.P.,CHT
- Edward Canoy
- Stephanie Cansler-Durr
- Alexandria Brittany Cantarero, MD
- Katherine Imelda Cante Pocasangre
- Miguel Alexander Cante, ASW
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.