NPIMap

Organization Active NPI

Marsha Mouton DDS, Inc

Doing business as La Tijera Dental Professionals

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1720478597
Registry record updated Jan 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
40688 Issued in CA
Legal business name
MARSHA MOUTON DDS, INC
Doing business as
La Tijera Dental Professionals
Practice address
6820 Latijera Blvd
Suite # 205
Los Angeles, CA 90045
Phone
(310) 256-4326
NPI assigned
Jan 30, 2015
Last updated
Jan 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2015

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

Authorized official

Name
Dr. Marsha Mouton, DDSNPI 1316141732
Title
Owner
Phone
(310) 256-4326

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 40688 CA Primary

Addresses

Primary practice location

6820 Latijera Blvd
Suite # 205
Los Angeles, CA 90045

Mailing address

6820 Latijera Blvd
Suite # 205
Los Angeles, CA 90045

Other names 1

  • La Tijera Dental Professionals Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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": "1422576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422576000000",
    "number": "1720478597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 LATIJERA BLVD",
            "address_2": "SUITE # 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 LATIJERA BLVD",
            "address_2": "SUITE # 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90045",
            "telephone_number": "310-256-4326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARSHA MOUTON DDS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-30",
        "last_updated": "2015-01-30",
        "status": "A",
        "authorized_official_last_name": "MOUTON",
        "authorized_official_first_name": "MARSHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-256-4326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "40688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "La Tijera Dental Professionals",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Jan 30, 2015; 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.