Individual provider Active NPI

Tristan D Hensley, DMD

  • Dentist
  • Lutz, FL
National Provider Identifier
1265840342
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN20815 Issued in FL
Practice address
1928 Highland Oaks Blvd
Lutz, FL 33559-7323
Phone
(813) 949-0424
NPI assigned
Aug 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20815 FL Primary

Addresses

Primary practice location

1928 Highland Oaks Blvd
Lutz, FL 33559-7323

Mailing address

4530 Grand Blvd
New Port Richey, FL 34652-5119
Phone (727) 849-4246

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN20815FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jay Andrew Nelson, D.M.D., P.a. Dentist PastSince Apr 25, 2021 Accepting new patients
Vincent J Monticciolo Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1406851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1265840342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4530 GRAND BLVD",
            "city": "NEW PORT RICHEY",
            "state": "FL",
            "postal_code": "346525119",
            "telephone_number": "727-849-4246",
            "fax_number": "727-849-0701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1928 HIGHLAND OAKS BLVD",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335597323",
            "telephone_number": "813-949-0424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENSLEY",
        "first_name": "TRISTAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-01",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20815",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lutz, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.