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General NPI Number Information
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NPI Number | 1285503888
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Entity Type | Individual
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Provider Name | MARY CRUS TRINIDAD RDH
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Gender | Female
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Dates
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Enumeration Date | 11/03/2025
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Last Update Date | 11/03/2025
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Provider Practice Location Address
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Address Line | 17897 MACARTHUR BLVD STE 100
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City | IRVINE
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State | CA
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Zip | 92614-0532
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Country | US
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Telephone | 949-251-8544
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Fax |
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Provider Business Mailing Address
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Address Line | 3894 BROTHERTON ST
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City | CORONA
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State | CA
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Zip | 92879-1809
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 34559
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H9123
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License Number State | OR
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