Trevor Joseph Madden, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

29974 Issued in TX

Practice address

16560 N. Ranch to Market 620 Rd.
104
Round Rock, TX 78681-5799

Phone

(402) 617-2707

NPI assigned

Jun 9, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402272000000",
    "number": "1558774471",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16560 N. RM 620 RD.",
            "address_2": "104",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "78681",
            "telephone_number": "402-617-2707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16560 N. RANCH TO MARKET 620 RD.",
            "address_2": "104",
            "city": "ROUND ROCK",
            "state": "TX",
            "postal_code": "786815799",
            "telephone_number": "402-617-2707"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MADDEN",
        "first_name": "TREVOR",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-09",
        "last_updated": "2014-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "29974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eunique Mackey, RBT
• Saydie Macneil
• Kathryn Marie Macon
• Madden Family Chiropractic PA
• John Madden
• Sherri Madera
• Jennifer Ann Madere, LPC
• Hala Madison, RN
• Maffeo Pediatric Therapy Management, LLC (Kidz Therapeze Round Rock)
• Lynne D. Maffeo, PT

• Dentist in Round Rock, TX
• Providers in Round Rock, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2014; 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.

Verify at the official NPI Registry.