Trevor Labrum, DDS, PLLC

Primary specialty

DentistTaxonomy code 122300000X

License

60580356 Issued in WA

Legal business name

TREVOR LABRUM, DDS, PLLC

Doing business as

Selah Family Dentistry

Practice address

112 S 2ND St
Selah, WA 98942-1308

Phone

(509) 728-9577

Fax

(509) 498-9887

NPI assigned

Jul 13, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Trevor Nichols Labrum, D.D.SNPI 1780098319

Title

Owner/Member

Phone

(509) 728-9577

Specialties & licenses 1

Addresses

Other names 1

• Selah Family Dentistry Doing business as

Locations

Practitioners 1

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

• Trevor Nichols Labrum, D.D.S.

  • Dentist
  • Riverton, UT
  • NPI 1780098319
  NPD (past) Authorized official

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

{
    "created_epoch": "1436745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1436745600000",
    "number": "1659755346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 S 2ND ST",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421308",
            "telephone_number": "509-728-9577",
            "fax_number": "509-498-9887"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 S 2ND ST",
            "city": "SELAH",
            "state": "WA",
            "postal_code": "989421308",
            "telephone_number": "509-728-9577",
            "fax_number": "509-498-9887"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREVOR LABRUM, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-13",
        "last_updated": "2015-07-13",
        "status": "A",
        "authorized_official_last_name": "LABRUM",
        "authorized_official_first_name": "TREVOR",
        "authorized_official_middle_name": "NICHOLS",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "509-728-9577",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "WA",
            "license": "60580356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Selah Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Selah, WA
• Providers in Selah, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2015; 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.