Provider Demographics
NPI:1265841217
Name:TRISTA ONESTI DDS, LLC
Entity Type:Organization
Organization Name:TRISTA ONESTI DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:TRISTA
Authorized Official - Middle Name:
Authorized Official - Last Name:ONESTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:216-849-6514
Mailing Address - Street 1:30799 PINETREE RD
Mailing Address - Street 2:#237
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5903
Mailing Address - Country:US
Mailing Address - Phone:216-849-6514
Mailing Address - Fax:
Practice Address - Street 1:1437 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:OH
Practice Address - Zip Code:44124-2449
Practice Address - Country:US
Practice Address - Phone:216-849-6514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-04
Last Update Date:2014-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH213811223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2273132Medicaid