Provider Demographics
NPI:1386757763
Name:TOMPKINS, TRENTON (DDS)
Entity type:Individual
Prefix:MR
First Name:TRENTON
Middle Name:
Last Name:TOMPKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WILLOW SPRINGS DR
Mailing Address - Street 2:
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-5240
Mailing Address - Country:US
Mailing Address - Phone:512-878-2540
Mailing Address - Fax:
Practice Address - Street 1:111 WILLOW SPRINGS DR
Practice Address - Street 2:
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666-5240
Practice Address - Country:US
Practice Address - Phone:512-878-2540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2018-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX28181122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX186252601Medicaid
TX8Y1890OtherBCBS
TX186252601Medicaid