Individual provider Active NPI

Terri Lynn Rogers, D.D.S.

  • General Practice Dentistry
  • Los Angeles, CA
National Provider Identifier
1790842417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
37599 Issued in CA
Practice address
6820 La Tijera Blvd Ste 205
Los Angeles, CA 90045-1931
Phone
(310) 670-2200
Fax
(310) 670-3189
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 37599 CA Primary

Addresses

Primary practice location

6820 La Tijera Blvd Ste 205
Los Angeles, CA 90045-1931

Mailing address

6820 La Tijera Blvd Ste 205
Los Angeles, CA 90045-1931
Phone (310) 670-2200

Other identifiers 1

IdentifierTypeStateIssuer
671459OtherUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170215001296 CA Order and Referring Only - DentistPractitioner - Dentist 4688854060

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
37599CAMDPharmacist

Interoperability endpoints

  • Direct secure messaging: trogers669744@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1790842417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6820 LA TIJERA BLVD STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451931",
            "telephone_number": "310-670-2200",
            "fax_number": "310-670-3189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6820 LA TIJERA BLVD STE 205",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900451931",
            "telephone_number": "310-670-2200",
            "fax_number": "310-670-3189"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROGERS",
        "first_name": "TERRI",
        "middle_name": "LYNN",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "37599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "671459",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.