Marsha E Mouton, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

40688 Issued in CA

Practice address

6820 La Tijera Blvd
Ste 205
Los Angeles, CA 90045-1908

Phone

(310) 256-4326

Fax

(310) 835-0088

NPI assigned

Jun 11, 2007

Last updated

Oct 28, 2024By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

• Marsha Mouton DDS, Inc

  dba La Tijera Dental Professionals

  • Dentist
  • Los Angeles, CA
  • NPI 1720478597
  Authorized official Same address or phone

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730073600000",
    "number": "1316141732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S MARKET ST STE 404",
            "city": "INGLEWOOD",
            "state": "CA",
            "postal_code": "903011712",
            "telephone_number": "310-890-3100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 LA TIJERA BLVD",
            "address_2": "STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451908",
            "telephone_number": "310-256-4326",
            "fax_number": "310-835-0088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOUTON",
        "first_name": "MARSHA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2024-10-28",
        "certification_date": "2024-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40688",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "40688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bahar Moussavian, MD
• Marwa Abdelmohsen Moustafa, MD
• Nehal Hamdi Ahmed Moustafa
• Melissa M Mouton-Jackson
• Casey Mouton
• Hastee Movafagh-Payman, D.D.S.
• Rana Movahedi, M.D.
• Kamran Movassaghi, MD
• Move Physical Therapy, PC
• Move to Wellness Inc

• General Practice Dentistry in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2024; 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.