Active NPI
Glenn Trautmann, DMD
- Endodontics
- Bedford, TX
National Provider Identifier
1992896294
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 20012
- Practice address
- 1100 Airport Fwy
Suite 105
Bedford, TX 76022-6667 - Phone
- (817) 267-3966
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 20012 | TX | Primary |
Addresses
Primary practice location
1100 Airport Fwy
Suite 105
Bedford, TX 76022-6667
Mailing address
1530 Blue Forest Dr
Prosper, TX 75078-9382
Phone (972) 347-9865
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 |
|---|---|---|---|
| 20012 | TX | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1992896294",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1530 BLUE FOREST DR",
"city": "PROSPER",
"state": "TX",
"postal_code": "750789382",
"telephone_number": "972-347-9865",
"fax_number": "972-347-9865"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 AIRPORT FWY",
"address_2": "SUITE 105",
"city": "BEDFORD",
"state": "TX",
"postal_code": "760226667",
"telephone_number": "817-267-3966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAUTMANN",
"first_name": "GLENN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "TX",
"license": "20012",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bedford, TX
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.