Provider Demographics
NPI:1396323804
Name:FOY, TRAYVON EDWARD (DDS)
Entity type:Individual
Prefix:DR
First Name:TRAYVON
Middle Name:EDWARD
Last Name:FOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC STREET HSB ROOM 241
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-0001
Mailing Address - Country:US
Mailing Address - Phone:206-543-7496
Mailing Address - Fax:206-685-7222
Practice Address - Street 1:1959 NE PACIFIC STREET HSB ROOM 241
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-7496
Practice Address - Fax:206-685-7222
Is Sole Proprietor?:No
Enumeration Date:2021-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADR61164248204E00000X
390200000X
WADR612481951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program