Individual provider Active NPI

Amy Trevor, DMD

  • General Practice Dentistry
  • Tualatin, OR
National Provider Identifier
1275960296
Registry record updated Nov 10, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D9913 Issued in OR
Practice address
18795 SW Boones Ferry Rd
Tualatin, OR 97062-8412
Phone
(503) 691-9046
NPI assigned
Oct 4, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2020

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 D9913 OR Primary

Addresses

Primary practice location

18795 SW Boones Ferry Rd
Tualatin, OR 97062-8412

Mailing address

18795 SW Boones Ferry Rd
Tualatin, OR 97062-8412

Other practice location 1

180 Main St
Aumsville, OR 97325-9806
Phone (503) 448-2555

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
D9913ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Hunsaker Dental General Practice Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1380844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604966400000",
    "number": "1275960296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18795 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18795 SW BOONES FERRY RD",
            "city": "TUALATIN",
            "state": "OR",
            "postal_code": "970628412",
            "telephone_number": "503-691-9046"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "180 Main St",
            "address_purpose": "LOCATION",
            "city": "Aumsville",
            "state": "OR",
            "postal_code": "973259806",
            "country_code": "US",
            "telephone_number": "503-448-2555",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREVOR",
        "first_name": "AMY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-10-04",
        "last_updated": "2020-11-10",
        "certification_date": "2020-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9913",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tualatin, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2020; 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.