Brandon Trevino, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

23264 Issued in TX

Legal business name

BRANDON TREVINO, DDS, PA

Practice address

1550 Norwood Dr
Suite 400
Hurst, TX 76054-3646

Phone

(817) 282-3411

Fax

(817) 268-3529

NPI assigned

Nov 23, 2010

Organization subpart

No

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

Authorized official

Name

Brandon Jay Trevino, DDSNPI 1568662690

Title

Owner

Phone

(817) 282-3411

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

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

• Brandon Jay Trevino, DDS

  • Dentist
  • Hurst, TX
  • NPI 1568662690
  NPD (past) Authorized official

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

{
    "created_epoch": "1290470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290470400000",
    "number": "1720380728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1550 NORWOOD DR",
            "address_2": "SUITE 400",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543646",
            "telephone_number": "817-282-3411",
            "fax_number": "817-268-3529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1550 NORWOOD DR",
            "address_2": "SUITE 400",
            "city": "HURST",
            "state": "TX",
            "postal_code": "760543646",
            "telephone_number": "817-282-3411",
            "fax_number": "817-268-3529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRANDON TREVINO, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-23",
        "last_updated": "2010-11-23",
        "status": "A",
        "authorized_official_last_name": "TREVINO",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "JAY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "817-282-3411",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "23264",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "189848820",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael-David Robert Bradford, LPC
• Amy Bradley
• David Brian Bradley, DC CCRD
• Tyler Brady, DMD
• Summer Noel Branch
• Laquita Shenay Brazile, LM
• Breaking the Cycle
• Brian C. Bui, DDS, PLLC
• Brian Rogers, DO (Performance Medical Clinics)
• Megan Bride, CCC-SLP

• General Practice Dentistry in Hurst, TX
• Providers in Hurst, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2010; 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.