Treavor D Fisher, DDS, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D9340 Issued in OR

Legal business name

TREAVOR D FISHER, DDS, LLC

Practice address

470 Highland Ave
Coos Bay, OR 97420-2243

Phone

(541) 269-2100

NPI assigned

Jun 19, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Treavor D Fisher, DDSNPI 1447520655

Title

Dentist

Phone

(541) 554-4734

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Treavor Fisher, D.D.S.

  • General Practice Dentistry
  • Coos Bay, OR
  • NPI 1447520655
  NPD (past) Authorized official
• Raymond Leslie French, D.M.D.

  • General Practice Dentistry
  • Coos Bay, OR
  • NPI 1689895062
  NPD (past)

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

{
    "created_epoch": "1340064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1340064000000",
    "number": "1962765453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "470 HIGHLAND AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202243",
            "telephone_number": "541-269-2100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "470 HIGHLAND AVE",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202243",
            "telephone_number": "541-269-2100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TREAVOR D FISHER, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-19",
        "last_updated": "2012-06-19",
        "status": "A",
        "authorized_official_last_name": "FISHER",
        "authorized_official_first_name": "TREAVOR",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "541-554-4734",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D9340",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane H Todd, ACNP
• Charles H Toledo, M.D.
• Michael Anthony Torres, MD, MBA
• Josephine Dela Cruz Torresani, R.D.,L.D.
• Alex Quang Tran, PHARMD
• Christopher Truong
• Carol Marie Tucker, M.A., CCC-SLP
• Rochelle Tucker, MD
• Sarah Susan Tucker, CRM
• Danielle Underwood, RDH

• 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 Jun 19, 2012; 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.