Provider Demographics
NPI:1417126913
Name:TRENT, BRIGID WALSH (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIGID
Middle Name:WALSH
Last Name:TRENT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 BALFOUR RD STE A
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:94513-4927
Mailing Address - Country:US
Mailing Address - Phone:925-308-7608
Mailing Address - Fax:925-308-7542
Practice Address - Street 1:2201 BALFOUR RD STE A
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:CA
Practice Address - Zip Code:94513-4927
Practice Address - Country:US
Practice Address - Phone:925-308-7608
Practice Address - Fax:925-308-7542
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-28
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA553451223P0221X
IL019.0270821223G0001X
FLHAD481223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL005537700Medicaid