MEDICARE: TRISTA ONESTI DDS, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0221X	Pediatric Dentistry	21381	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1265841217
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TRISTA ONESTI DDS, LLC

Provider Business Mailing Address
First Line	:	30799 PINETREE RD
Second Line	:	#237
City	:	PEPPER PIKE
State	:	OH
Zip	:	44124-5903
Country	:	US
Telephone Number	:	216-849-6514
Fax Number	:

Provider Business Practice Location Address
First Line	:	1437 RICHMOND RD
Second Line	:
City	:	LYNDHURST
State	:	OH
Zip	:	44124-2449
Country	:	US
Telephone Number	:	216-849-6514
Fax Number	:

Authorized Official
Title or Position	:	OWNER/DENTIST
Name	:	TRISTA ONESTI
Credential	:
Telephone Number	:	216-849-6514

Provider Enumeration Date	:	08/04/2014
Last Update Date	:	08/04/2014

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