Treavor Fisher, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9340 Issued in OR

Practice address

328 S 2ND St
Coos Bay, OR 97420-1606

Phone

(541) 269-2100

NPI assigned

Jan 4, 2012

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Treavor D Fisher, DDS, LLC

  • General Practice Dentistry
  • Coos Bay, OR
  • NPI 1962765453
  NPD (past) Authorized official

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

{
    "created_epoch": "1325635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676332800000",
    "number": "1447520655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "328 S 2ND ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201606",
            "telephone_number": "541-269-2100",
            "fax_number": "541-267-7241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "328 S 2ND ST",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974201606",
            "telephone_number": "541-269-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "TREAVOR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-04",
        "last_updated": "2023-02-14",
        "certification_date": "2023-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigitte D Fink, MD
• Destin Kie Finnegan
• Sean Finnegan, PA-C
• Robin Sue Finney, PMHNP
• Carrie Lynn Fisher
• Brandy Flood, MASSAGE THERAPY
• Flowing Function LLC
• FM Ocean Crest, LLC (Bayside Terrace Assisted Living and Memory Care)
• FM Ocean Ridge, LLC (Ocean Ridge Assisted Living)
• Jenifer Lynn Folau

• General Practice Dentistry in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• General Practice Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2023; 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.