Provider Demographics
NPI:1053475681
Name:TRINIDAD, MARIA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:L
Last Name:TRINIDAD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8338 N LOOP 1604 W STE 104
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78249-3482
Mailing Address - Country:US
Mailing Address - Phone:210-877-9100
Mailing Address - Fax:214-292-6545
Practice Address - Street 1:8338 N LOOP 1604 W STE 104
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-3482
Practice Address - Country:US
Practice Address - Phone:210-877-9100
Practice Address - Fax:518-869-1965
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2022-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0502221223G0001X
TX381891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY050222OtherNEW YORK STATE LICENSE
TX38189OtherGENERAL DENTIST