Active NPI
Chase Bingham Trejo, DDS
- General Practice Dentistry
- Meridian, ID
National Provider Identifier
1962906156
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D-5025
- Practice address
- 2275 S Eagle Rd Ste 140
Meridian, ID 83642 - Phone
- (208) 215-7449
- NPI assigned
- Mar 21, 2018
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D-5025 | ID | Primary |
Addresses
Primary practice location
2275 S Eagle Rd Ste 140
Meridian, ID 83642
Mailing address
9309 S Copeland Way
Kuna, ID 83634-4805
Phone (512) 484-2913
Other practice location 1
530 S Wakara Way
Salt Lake City, UT 84108-1213
Phone (801) 587-2162
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D-5025 | ID | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1565049600000",
"number": "1962906156",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9309 S COPELAND WAY",
"city": "KUNA",
"state": "ID",
"postal_code": "836344805",
"telephone_number": "512-484-2913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2275 S EAGLE RD STE 140",
"city": "MERIDIAN",
"state": "ID",
"postal_code": "83642",
"telephone_number": "208-215-7449"
}
],
"practiceLocations": [
{
"address_1": "530 S Wakara Way",
"address_purpose": "LOCATION",
"city": "Salt Lake City",
"state": "UT",
"postal_code": "841081213",
"country_code": "US",
"telephone_number": "801-587-2162",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TREJO",
"first_name": "CHASE",
"middle_name": "BINGHAM",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2018-03-21",
"last_updated": "2019-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "ID",
"license": "D-5025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Meridian, ID
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- Treasure Valley Urology PLLC
- Treasure Wellness, PLLC
- Tree City Therapy LLC
- Audrey Nicole Tripp
- Trone Health Services Inc (Medicap Pharmacy #8362)
- Trone Health Services Inc (Medicap Pharmacy)
- Devin R Trone, PHARMD
- Rachel Troughton, M.ED CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.