Active NPI
Todd Michael Trimboli, DDS
- General Practice Dentistry
- Lavalette, WV
National Provider Identifier
1396821526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2951
- Practice address
- 4751 RT 152
Lavalette, WV 25535-0158 - Phone
- (304) 529-2036
- NPI assigned
- Oct 31, 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2951 | WV | Primary |
Addresses
Primary practice location
4751 RT 152
Lavalette, WV 25535-0158
Mailing address
PO Box 158
4751 RT 152
Lavalette, WV 25535-0158
Phone (304) 529-2036
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0132858000 | Medicaid | WV |
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 |
|---|---|---|---|
| 2951 | WV | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162252800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396821526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 158",
"address_2": "4751 RT 152",
"city": "LAVALETTE",
"state": "WV",
"postal_code": "255350158",
"telephone_number": "304-529-2036"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4751 RT 152",
"city": "LAVALETTE",
"state": "WV",
"postal_code": "255350158",
"telephone_number": "304-529-2036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRIMBOLI",
"first_name": "TODD",
"middle_name": "MICHAEL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-31",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "WV",
"license": "2951",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0132858000",
"state": "WV"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Lavalette, WV
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.