Active NPI
Kenneth Charles Troutman, DDS
- Pediatric Dentistry
- Los Angeles, CA
National Provider Identifier
1922189331
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 51747
- Practice address
- 10833 Le Conte Ave
Los Angeles, CA 90095 - Phone
- (310) 825-5619
- Fax
- (310) 825-8728
- NPI assigned
- Oct 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 51747 | CA | Primary |
Addresses
Primary practice location
10833 Le Conte Ave
Los Angeles, CA 90095
Mailing address
PO Box 951668
Los Angeles, CA 90095
Phone (310) 206-5118
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
| License | State | Type | Specialty |
|---|---|---|---|
| 51747 | CA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161216000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922189331",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 951668",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90095",
"telephone_number": "310-206-5118",
"fax_number": "310-825-8728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10833 LE CONTE AVE",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "90095",
"telephone_number": "310-825-5619",
"fax_number": "310-825-8728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TROUTMAN",
"first_name": "KENNETH",
"middle_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CA",
"license": "51747",
"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 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.