Individual provider Active NPI

Trevor Eide

  • Pediatric Dentistry
  • Columbus, OH
National Provider Identifier
1114672623
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
30.028214 Issued in OH
Practice address
700 Childrens Dr
Columbus, OH 43205-2664
Phone
(614) 722-5651
NPI assigned
Feb 14, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.028214 OH
Pediatric Dentistry 1223P0221X 30.028214 OH Primary

Addresses

Primary practice location

700 Childrens Dr
Columbus, OH 43205-2664

Mailing address

700 Childrens Dr
Columbus, OH 43205-2664
Phone (614) 722-2000

Other practice location 1

405 Butterfly Gardens Dr
Columbus, OH 43215-4985
Phone (614) 722-5650

Other practice location 2

380 Butterfly Gardens Dr
Columbus, OH 43215-7508
Phone (614) 722-5650

Other identifiers 1

IdentifierTypeStateIssuer
0007294MedicaidOH

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240627000467 MO Practitioner - Pediatric DentistryPractitioner - Dentist 1658815014 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.028214OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Compass Health, Inc CurrentSince Jun 19, 2024 Accepting new patients
Compass Health, Inc CurrentSince Jun 19, 2024 Accepting new patients
Nationwide Children'S Hospital Past Accepting new patients

Locations

1800 Community
Clinton, MO 64735
Phone (660) 885-8131

1800 Community
#B
Clinton, MO 64735

303 N Keene St
Ste 202
Columbia, MO 65201
Phone (573) 442-8885

2475 Broadway Bluffs Dr
Ste 200
Columbia, MO 65201
Phone (573) 777-9282

1101 N Providence Rd
Columbia, MO 65203
Phone (573) 777-8997

1001 W Worley St
Columbia, MO 65203
Phone (573) 214-2314

2475 Broadway Bluffs Dr
Columbia, MO 65201
Phone (573) 777-9282

200 Portland St
Columbia, MO 65201
Phone (573) 886-4600

1600 N Missouri Ave
Marceline, MO 64658
Phone (660) 376-2038

1517 Union Ave
Ste C
Moberly, MO 65270
Phone (660) 263-4800

307 S Broadway
Salisbury, MO 65281
Phone (660) 388-6446

Interoperability endpoints

  • Direct secure messaging: trevor.eide.p1@direct.compasshn.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1644796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1114672623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 CHILDRENS DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432052664",
            "telephone_number": "614-722-5651"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432154985",
            "country_code": "US",
            "telephone_number": "614-722-5650",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "380 Butterfly Gardens Dr",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432157508",
            "country_code": "US",
            "telephone_number": "614-722-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EIDE",
        "first_name": "TREVOR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-14",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.028214",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.028214",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0007294",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.