Trevor McCollough, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D13918 Issued in MN

Practice address

4707 E Superior St
Duluth, MN 55804-2339

Phone

(218) 525-1921

NPI assigned

Jun 22, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• M Dental PLLC

  • Dental Clinic/Center
  • Duluth, MN
  • NPI 1609425032
  NPD Authorized official

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572480000000",
    "number": "1598285454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042043",
            "telephone_number": "207-332-0028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4707 E SUPERIOR ST",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558042339",
            "telephone_number": "218-525-1921"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Waterfront Dr",
            "address_purpose": "LOCATION",
            "city": "Two Harbors",
            "state": "MN",
            "postal_code": "556161525",
            "country_code": "US",
            "telephone_number": "218-834-2354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "TREVOR",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-22",
        "last_updated": "2019-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "ME",
            "license": "DEN4572",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D13918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Charles McBride
• Diane M. McCaffrey, M.D.
• Kathleen McCarty
• Amy M McClellan
• Mary Rose McClernon, LICSW
• Ashley McConnell
• Rachel McCorison
• Elyse Marilee McCoshen, CCC/SLP
• Lynea Darby McCulloch
• Sara Ann McCumber

• General Practice Dentistry in Duluth, MN
• Providers in Duluth, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.