Provider Demographics
NPI:1053389809
Name:TRENT, JOCELYN D (MD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:D
Last Name:TRENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:5336 CHANDLEY FARM CIR
Mailing Address - Street 2:
Mailing Address - City:CENTREVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20120-1237
Mailing Address - Country:US
Mailing Address - Phone:703-802-1665
Mailing Address - Fax:
Practice Address - Street 1:2296 OPITZ BLVD
Practice Address - Street 2:SUITE 403
Practice Address - City:WOODBRIDGE
Practice Address - State:VA
Practice Address - Zip Code:22191-3300
Practice Address - Country:US
Practice Address - Phone:703-878-2233
Practice Address - Fax:703-878-2254
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VAVA-0101045484208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAVA-0101045484Medicare UPIN