Tais Trevelin DMD Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

TAIS TREVELIN DMD INC

Practice address

12378 Poway Rd Ste B
Poway, CA 92064-4242

Phone

(858) 679-8918

Fax

(858) 679-6993

NPI assigned

Dec 15, 2023

Organization subpart

No

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

Authorized official

Name

Tais Trevelin Lowry, DMD

Title

President

Phone

(509) 508-7395

Specialties & licenses 1

Addresses

Other names 3

• Capri Dentistry Doing business as
• Poway Dental Center Doing business as
• Poway Family Dental Center Doing business as

Practitioners 1

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

• Tais Trevelin Lowry, DMD

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1053920934
  NPD

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

{
    "created_epoch": "1702598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1497523732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12378 POWAY RD STE B",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644242",
            "telephone_number": "858-679-8918",
            "fax_number": "858-679-6993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12378 POWAY RD STE B",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "920644242",
            "telephone_number": "858-679-8918",
            "fax_number": "858-679-6993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TAIS TREVELIN DMD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-15",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "LOWRY",
        "authorized_official_first_name": "TAIS TREVELIN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "509-508-7395",
        "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": "Capri Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Poway Dental Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Poway Family Dental Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Catherine Szkatulski, OTR/L
• Brooke Marie Szymanski
• Sterlingsilver Tabasa
• Tae Hun Chung DDS Inc
• Kuangkai Tai, MD
• Richelle Taitano
• Michael M. Takamura, MD
• David Akira Tam, MD
• Mariah Lacel Tamayo
• Luyang Tan, AC12693

• General Practice Dentistry in Poway, CA
• Providers in Poway, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 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.