Tatiana Trott, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE60135332 Issued in WA

Practice address

Meadowlark Family Dentistry
306 Vine St
Kelso, WA 98626

Phone

(360) 577-3625

Fax

(360) 638-3051

NPI assigned

Jan 4, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665446400000",
    "number": "1144550773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "306 VINE ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "98626",
            "telephone_number": "360-577-3625",
            "fax_number": "360-538-3051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEADOWLARK FAMILY DENTISTRY",
            "address_2": "306 VINE ST",
            "city": "KELSO",
            "state": "WA",
            "postal_code": "98626",
            "telephone_number": "360-577-3625",
            "fax_number": "360-638-3051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTT",
        "first_name": "TATIANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-04",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "58977",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60135332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2006950",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Kelso, WA
• Providers in Kelso, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.