Mary K Trejo Hernandez, DOCTOR IN DENTAL

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

107386 Issued in CA

Practice address

9867 Magnolia Ave Ste E
Riverside, CA 92503-3519

Phone

(951) 352-2112

Fax

(951) 352-2088

NPI assigned

Jun 12, 2022

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1654992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654992000000",
    "number": "1760112940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9867 MAGNOLIA AVE STE E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033519",
            "telephone_number": "951-352-2112",
            "fax_number": "951-352-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9867 MAGNOLIA AVE STE E",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925033519",
            "telephone_number": "951-352-2112",
            "fax_number": "951-352-2088"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17072 Whispering Brook Way",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "CA",
            "postal_code": "925036558",
            "country_code": "US",
            "telephone_number": "951-842-0663",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TREJO HERNANDEZ",
        "first_name": "MARY",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "DOCTOR IN DENTAL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-12",
        "last_updated": "2022-06-12",
        "certification_date": "2022-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "107386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Transnet Medical Transportation, LLC
• Travis D Tramel Rdhap, Inc
• Michael Travis
• Belynda Treadwell
• Juan Eduardo Trejo Hernandez, DDS
• Brianna Gabrielle Trejo, RN
• Bryanna Trejo
• Elvia Trejo
• Mariah Trejo
• Sasha Brigett Trejos, LCSW

• General Practice Dentistry in Riverside, CA
• Providers in Riverside, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2022; 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.