Trent Ichiuji, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

064669 Issued in NY

Practice address

4 Care LN
Saratoga Springs, NY 12866-8624

Phone

(518) 583-4497

NPI assigned

Mar 12, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 21, 2025 through Jul 21, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• Healthfirst Medicare Network H3359
• Healthfirst Medicare Network H5989
• Healthfirst Medicare Network H1722
• Healthfirst Medicare Network H9678

Interoperability endpoints

• Direct secure messaging: tichiuji@montefioredirect.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Saratoga County Oral & Maxillofacial Surgery Associates

  • Oral and Maxillofacial Surgery (Dentist)
  • Saratoga Springs, NY
  • NPI 1639196637
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1520812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1255834602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 CARE LN",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668624",
            "telephone_number": "518-583-4497",
            "fax_number": "518-583-3779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 CARE LN",
            "city": "SARATOGA SPRINGS",
            "state": "NY",
            "postal_code": "128668624",
            "telephone_number": "518-583-4497"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 E 210th St",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104672401",
            "country_code": "US",
            "telephone_number": "718-920-4321",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ICHIUJI",
        "first_name": "TRENT",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-03-12",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NY",
            "license": "064669",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Huston
• Mary Ellen Hutchesonmsed, MSEDCCC-SLPNY LISSLP
• Heather M Hynick, MSN ANP-C, FNP-C
• Thomas Kyle Iacobelli, D.C.
• Amy Susan Iannon, RPH
• Inadvance Medicine Associates East
• Rebecca S Insonia-Smith, LCSWR
• Integral Health Physical Therapy PC
• Nicole Ionescu, MSED., LMHC-LP
• Hope Ellen Irion, LCAT

• Oral and Maxillofacial Surgery (Dentist) in Saratoga Springs, NY
• Providers in Saratoga Springs, NY by specialty
• Oral and Maxillofacial Surgery (Dentist) in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.