Provider Demographics
NPI:1922789387
Name:TREVOR F MAPLES DDS LLC
Entity Type:Organization
Organization Name:TREVOR F MAPLES DDS LLC
Other - Org Name:YELLOW SPRINGS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST, OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPLES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:240-252-8638
Mailing Address - Street 1:2100 OLD FARM DR STE 1F
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-9494
Mailing Address - Country:US
Mailing Address - Phone:301-663-1700
Mailing Address - Fax:301-696-2837
Practice Address - Street 1:2100 OLD FARM DR STE 1F
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9494
Practice Address - Country:US
Practice Address - Phone:301-663-1700
Practice Address - Fax:301-696-2837
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-28
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment