Provider Demographics
NPI:1255337853
Name:TRIMBLE, LORNE D (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:LORNE
Middle Name:D
Last Name:TRIMBLE
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 116TH AVE NE
Mailing Address - Street 2:STE 101
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-3825
Mailing Address - Country:US
Mailing Address - Phone:425-453-6975
Mailing Address - Fax:425-453-7825
Practice Address - Street 1:1370 116TH AVE NE
Practice Address - Street 2:STE 101
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3825
Practice Address - Country:US
Practice Address - Phone:425-453-6975
Practice Address - Fax:425-453-7825
Is Sole Proprietor?:No
Enumeration Date:2005-06-28
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA58771223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA55262Medicare UPIN