Organization Active NPI

Araceli Stout D.D.S. Inc.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1659746881
Registry record updated Dec 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
64440 Issued in CA
Legal business name
ARACELI STOUT D.D.S. INC.
Practice address
4762 Whittier Blvd
Los Angeles, CA 90022-3026
Phone
(323) 604-9555
Fax
(323) 604-9555
NPI assigned
Dec 14, 2015
Last updated
Dec 14, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2015

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

Authorized official

Name
Araceli Stout, D.D.S.NPI 1043699754
Title
Dentist
Phone
(323) 604-9555

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 64440 CA Primary

Addresses

Primary practice location

4762 Whittier Blvd
Los Angeles, CA 90022-3026

Mailing address

4762 Whittier Blvd
Los Angeles, CA 90022-3026
Phone (323) 604-9555

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190919000340 CA Part B Supplier - Clinic/Group Practice 1557691466 Receives reassigned benefits from 1 practitioner
Practice locations: Los Angeles, CA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1450051200000",
    "number": "1659746881",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4762 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223026",
            "telephone_number": "323-604-9555",
            "fax_number": "323-604-9555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4762 WHITTIER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900223026",
            "telephone_number": "323-604-9555",
            "fax_number": "323-604-9555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARACELI STOUT D.D.S. INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2015-12-14",
        "status": "A",
        "authorized_official_last_name": "STOUT",
        "authorized_official_first_name": "ARACELI",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "323-604-9555",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "64440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.