Provider Demographics
NPI:1154528081
Name:JAMES R. TRINITY, DDS
Entity type:Organization
Organization Name:JAMES R. TRINITY, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:TRINITY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-547-3656
Mailing Address - Street 1:633 N CENTRAL AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91203-1801
Mailing Address - Country:US
Mailing Address - Phone:818-547-3656
Mailing Address - Fax:818-547-0646
Practice Address - Street 1:633 N CENTRAL AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91203-1801
Practice Address - Country:US
Practice Address - Phone:818-547-3656
Practice Address - Fax:818-547-0646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA198101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty