Active NPI
Leo V. Trail Jr., D.D.S., M.S., P.A.
- Periodontics
- Forest Hill, MD
National Provider Identifier
1245384270
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 7077
- Practice address
- 2 Colgate Dr
Suite 103
Forest Hill, MD 21050-2624 - Phone
- (410) 836-8567
- Fax
- (410) 836-9677
- NPI assigned
- Jan 23, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 7077 | MD | Primary |
Addresses
Primary practice location
2 Colgate Dr
Suite 103
Forest Hill, MD 21050-2624
Mailing address
2 Colgate Dr.
Suite 103
Forest Hill, MD 21050
Phone (410) 836-8567
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MD
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160126000087 | MD | Order and Referring Only - Other (Physician) | 3971806944 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science, Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7077 | MD | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169510400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1245384270",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 COLGATE DR.",
"address_2": "SUITE 103",
"city": "FOREST HILL",
"state": "MD",
"postal_code": "21050",
"telephone_number": "410-836-8567",
"fax_number": "410-836-9677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 COLGATE DR",
"address_2": "SUITE 103",
"city": "FOREST HILL",
"state": "MD",
"postal_code": "210502624",
"telephone_number": "410-836-8567",
"fax_number": "410-836-9677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRAIL",
"first_name": "LEO",
"middle_name": "V.",
"name_suffix": "Jr.",
"credential": "D.D.S., M.S., P.A.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-01-23",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MD",
"license": "7077",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Forest Hill, MD
- Annabelle Thomas
- Sarah Erline Thomas, LCSW-C
- Kristine A Thurlow, PA-C
- Deborah Ann Tippett, OTR
- Ann J Tobin, RN
- Randall Lee Tressler, M.D.
- True Sports Physical Therapy, LLC
- Rebecca Trump, MS, LMT
- Ultimate Hearing Solutions III (Miracle Ear)
- Umms Ambulatory Care LLC (University of Maryland Urgent Care-Forest Hill)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.