Trever L Siu, D.M.D., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

6841 Issued in AZ

Practice address

13065 W McDowell Rd
Suite A101
Avondale, AZ 85392-6439

Phone

(623) 935-0004

NPI assigned

Feb 9, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 5, 2015 through Oct 5, 2027

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

Practice roles

Interoperability endpoints

• Direct secure messaging: tsiu18646@direct.midwestern.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Midwestern University

  • Dental Clinic/Center
  • Glendale, AZ
  • NPI 1164744009
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406592000000",
    "number": "1215078712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2767 E PALMER ST",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852985749",
            "telephone_number": "480-895-0801"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13065 W MCDOWELL RD",
            "address_2": "SUITE A101",
            "city": "AVONDALE",
            "state": "AZ",
            "postal_code": "853926439",
            "telephone_number": "623-935-0004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIU",
        "first_name": "TREVER",
        "middle_name": "L",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2014-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "AZ",
            "license": "6841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Simon, DPT
• Cory Robert Simons, D.C.
• Isabel C Simpson, D.M.D
• Gurkaran Singh, MD
• Shreya Singh
• Austin Skamser
• Katherine Skarlis, RD
• Jade Skousen
• Tera Smeltzer
• Smi Imaging, LLC

• Periodontics in Avondale, AZ
• Providers in Avondale, AZ by specialty
• Periodontics in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.