Trevor Tafoya DDS Victory Dental, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TREVOR TAFOYA DDS VICTORY DENTAL, PLLC

Practice address

7421 W Victory Rd
Boise, ID 83709-5106

Phone

(208) 402-1040

Fax

(866) 324-2220

NPI assigned

May 11, 2019

Organization subpart

No

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

Authorized official

Name

Trevor Tafoya, DMDNPI 1790126845

Title

President

Phone

(208) 447-7555

Specialties & licenses 1

Addresses

Other names 1

• Victory Dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Trevor E Tafoya, D.M.D.

  • General Practice Dentistry
  • Boise, ID
  • NPI 1790126845
  NPD (past) Authorized official

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

{
    "created_epoch": "1557532800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1557532800000",
    "number": "1124684584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2598 E LA GRANGE DR",
            "city": "MERIDIAN",
            "state": "ID",
            "postal_code": "836424773",
            "telephone_number": "208-447-7555",
            "fax_number": "866-324-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7421 W VICTORY RD",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837095106",
            "telephone_number": "208-402-1040",
            "fax_number": "866-324-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVOR TAFOYA DDS VICTORY DENTAL, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-11",
        "last_updated": "2019-05-11",
        "status": "A",
        "authorized_official_last_name": "TAFOYA",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "208-447-7555",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Victory Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Cynthia Tremblay, PSY.D.
• Darla Kay Trent, LCPC
• Erin Trent
• Heather Rose Tresidder, FNP-C
• Trestle Behavioral Health LLC
• Annika Tribby, M.S. CCC-SLP
• Christine Trifiletti
• Michael J Trimble, PA-C
• Khai Tuan Trinh, LPC
• Trinity Anesthesia LLC

• General Practice Dentistry in Boise, ID
• Providers in Boise, ID by specialty
• General Practice Dentistry in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2019; 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.