Individual provider Active NPI

John H Trotter, DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Redondo Beach, CA
National Provider Identifier
1215067160
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
39215 Issued in CA
Practice address
1706 S Elena Ave #D
Redondo Beach, CA 90277-5715
Phone
(310) 373-0093
Fax
(310) 378-3033
NPI assigned
Mar 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 39215 CA Primary

Addresses

Primary practice location

1706 S Elena Ave #D
Redondo Beach, CA 90277-5715

Mailing address

1706 S Elena Ave #D
Redondo Beach, CA 90277-5715
Phone (310) 373-0093

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
39215CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215067160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1706 S ELENA AVE #D",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775715",
            "telephone_number": "310-373-0093",
            "fax_number": "310-378-3033"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 S ELENA AVE #D",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775715",
            "telephone_number": "310-373-0093",
            "fax_number": "310-378-3033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROTTER",
        "first_name": "JOHN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "CA",
            "license": "39215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redondo Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.