Active NPI
Vincent Trinidad, DMD
- Dentist
- Eureka, CA
National Provider Identifier
1629477880
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63882
- Practice address
- 959 Myrtle Ave
Eureka, CA 95501-1219 - Phone
- (707) 442-7078
- Fax
- (707) 442-7298
- NPI assigned
- Aug 13, 2014
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 63882 | CA | Primary |
Addresses
Primary practice location
959 Myrtle Ave
Eureka, CA 95501-1219
Mailing address
670 9TH St
Suite 203
Arcata, CA 95521-6248
Phone (707) 826-8633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- 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 |
|---|---|---|---|---|
| I20221111000439 | MA | Order and Referring Only - Dentist | 1456728047 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63882 | CA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407888000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407888000000",
"number": "1629477880",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "670 9TH ST",
"address_2": "SUITE 203",
"city": "ARCATA",
"state": "CA",
"postal_code": "955216248",
"telephone_number": "707-826-8633",
"fax_number": "707-826-8638"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "959 MYRTLE AVE",
"city": "EUREKA",
"state": "CA",
"postal_code": "955011219",
"telephone_number": "707-442-7078",
"fax_number": "707-442-7298"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TRINIDAD",
"first_name": "VINCENT",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-13",
"last_updated": "2014-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eureka, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 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.