Individual provider Active NPI

Gary Wood Troutman, D.D.S.

  • General Practice Dentistry
  • Prescott, AZ
National Provider Identifier
1851313944
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.013378 Issued in OH
Practice address
500 N. Hwy 89
PSC 160
Prescott, AZ 86313-5001
Phone
(928) 776-6177
Fax
(928) 776-6131
NPI assigned
Jul 24, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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
General Practice Dentistry 1223G0001X 30.013378 OH Primary

Addresses

Primary practice location

500 N. Hwy 89
PSC 160
Prescott, AZ 86313-5001

Mailing address

PO Box 9092
Prescott, AZ 86313-9092
Phone (928) 445-1372

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

State licenses

LicenseStateTypeSpecialty
30.013378OHMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1153699200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1851313944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9092",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863139092",
            "telephone_number": "928-445-1372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N. HWY 89",
            "address_2": "PSC 160",
            "city": "PRESCOTT",
            "state": "AZ",
            "postal_code": "863135001",
            "telephone_number": "928-776-6177",
            "fax_number": "928-776-6131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TROUTMAN",
        "first_name": "GARY",
        "middle_name": "WOOD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.013378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prescott, AZ

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.