Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Trenten James Dippold, PA

Individual provider Physician Assistant · NPI 1700618790

Trenten James Dippold, PA is a Physician Assistant in Phoenix, Arizona. Qualified in 2024, 2 years ago. Practices with Banner - University Primary Care Physicians LLC, a 45-clinician group and accepts Medicare assignment. Licensed in Arizona.

Years since qualifying
2
Licensed in
AZ
In the registry since
2024
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1300 N 12th St Ste 500
Phoenix, AZ 85006-2849
Phone: (602) 839-4567
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10657 (AZ)

Record details

NPI number1700618790
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedAugust 17, 2024
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Banner - University Primary Care Physicians Llc — 45 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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