Healthcare Provider Details

I. General information

NPI: 1114831302
Provider Name (Legal Business Name): TREVOR JAMAL THOMAS DDS DC PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 QUINCY ST NE
WASHINGTON DC
20017-1738
US

IV. Provider business mailing address

572 HANK AARON DR SE STE 4100
ATLANTA GA
30312-2899
US

V. Phone/Fax

Practice location:
  • Phone: 424-448-2862
  • Fax:
Mailing address:
  • Phone: 424-448-2862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: VIOLET AQUINO
Title or Position: MANAGER
Credential:
Phone: 424-448-2862