DR. TRENTON D CUSTIS (NPI# 1356575344) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356575344 |
| Entity Type | Individual |
| Full Name | DR. TRENTON D CUSTIS |
| Credential | M.D. |
| Practice Address |
3900 Junius St Ste 710 Dallas TX 75246-1627 |
| Mailing Address |
12700 Park Central Dr Ste 650 Dallas TX 75251-1522 |
| Practice Telephone | 2149873376 |
| Mailing Telephone | 2149873376 |
| Enumeration Date | 2009-05-06 |
| Last Update Date | 2014-09-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207N00000X | Dermatology | A114739 | CA | Allopathic & Osteopathic Physicians |
| Y | 207ND0101X |
Dermatology Specialization: MOHS-Micrographic Surgery |
Q0623 | TX | Allopathic & Osteopathic Physicians |
| Street Address |
3900 JUNIUS ST STE 710 |
| City | DALLAS |
| State | TX |
| Zip Code | 75246-1627 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396201356 | Roseann Estrada Mendoza | Nurse Practitioner | 3600 Gaston Ave., Barnett Tower, Suite 711, Dallas, TX 75246 | 2019-02-14 |
| 1033683701 | Marta Revilla-leon | Dentist | 3302 Gaston Avenue, College of Dentistry, Texas A&m Uni, Room 713, Dallas, TX 75246 | 2019-01-16 |
| 1912408170 | Liza Johannesson | Transplant Surgery | Baylor University Medical Center, 3410 Worth Street, Ste 950, Dallas, TX 75246 | 2018-02-23 |
| 1841710266 | Stephanie Chartier-plante | Student in an Organized Health Care Education/Training Program | 3501 Junius St, Jonsson Hospital, Dallas, TX 75246 | 2017-06-27 |
| 1528505096 | Adam Bohnenblust | Chiropractor | 411 N Washington Ave Ste 2200, Dallas, TX 75246 | 2017-01-23 |
| 1699121327 | Magnolia Pain Associates Pllc | Pain Medicine | 3801 Gaston Ave Ste 318- 320, Dallas, TX 75246 | 2016-05-12 |
| 1073969408 | Apurva Yeluru | Hospitalist | 3500 Gaston Ave Ste 550, Dallas, TX 75246 | 2016-05-04 |
| 1134580533 | Sp Alf Ops Co, LLC | Assisted Living Facility | 3922 Simpson Street, Dallas, TX 75246 | 2016-03-11 |
| 1386031185 | Lisa Voigt | Student in an Organized Health Care Education/Training Program | 3501 Junius Street, Dallas, TX 75246 | 2015-04-20 |
| 1891107843 | Jessica Shie | Internal Medicine | Baylor Scott & White - Hospital Medicine Dallas, 3600 Gaston Ave., Wadley #550, Dallas, TX 75246 | 2014-05-27 |
| Find all providers in zip 75246 | ||||
| Taxonomy Code | 207ND0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | MOHS-Micrographic Surgery |
| The highly-trained surgeons that perform Mohs Micrographic Surgery are specialists both in dermatology and pathology. With their extensive knowledge of the skin and unique pathological skills, they are able to remove only diseased tissue, preserving healthy tissue and minimizing the cosmetic impact of the surgery. Mohs surgeons who belong to the American College of Mohs Surgery (ACMS) have completed a minimum of one year of fellowship training at one of the ACMS-approved training centers in the U.S. |
| Notes: Source: American College of Mohs Surgery, 2007 [1/1/2008: added definition, added source] Additional Resources: Additional Resources: http://www.mohscollege.org/; American Board of Dermatology, 2007. http://www.abderm.org/ |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457695413 | Oliver Street 5.01(a) Inc. | Dermatology | 5310 Harvest Hill Rd Ste 290, Dallas, TX 75230-5826 | 2012-11-15 |
| 1710961248 | Willis I Cottel | Dermatology | 2215 Cedar Springs Rd, Suite 1101, Dallas, TX 75201-1859 | 2005-11-29 |
| 1972906592 | Texas Mohs Surgery and Skin Cancer Center, Pllc | Dermatology | 411 N Washington Ave, Suite 1200, Dallas, TX 75246-1744 | 2014-09-28 |
| 1538591532 | Sarah J Felton | Dermatology | 5201 Harry Hines Blvd, Graduate Medical Education, Dallas, TX 75235-7708 | 2013-08-01 |
| 1952538043 | Rajiv I Nijhawan | Dermatology | 5939 Harry Hines Blvd, Dallas, TX 75390-7201 | 2009-06-16 |
| 1578701868 | Daniel D. Witheiler, M.d. P.a. | Dermatology | 1411 N Beckley Ave, Pavilion IIi, Suite 470, Dallas, TX 75203-1259 | 2009-01-26 |
| 1215138599 | Thornwell H Parker IIi M D P A | Dermatology | 8230 Walnut Hill Ln Ste 808, Dallas, TX 75231-4469 | 2007-05-31 |
| 1689738619 | Thornwell Hay Parker IIi | Dermatology | 8230 Walnut Hill Ln Ste 808, Suite 808, Dallas, TX 75231-4469 | 2006-12-21 |
| 1760441893 | Robert Stanley Taylor IIi | Dermatology | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-03-18 |
| 1023083482 | Daniel D. Witheiler | Dermatology | 1411 N Beckley Ave, Pavilion IIi, Suite 470, Dallas, TX 75203-1264 | 2006-02-21 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.