Individual provider Active NPI

Justin Matthew Trisler, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Oak Ridge, TN
National Provider Identifier
1902819618
Registry record updated Apr 27, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
10191 Issued in TN
Practice address
1143 Oak Ridge Tpke Ste 206
Oak Ridge, TN 37830-6482
Phone
(865) 312-6264
NPI assigned
Aug 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X 10191 TN Primary

Addresses

Primary practice location

1143 Oak Ridge Tpke Ste 206
Oak Ridge, TN 37830-6482

Mailing address

1143 Oak Ridge Tpke Ste 206
Oak Ridge, TN 37830-6482
Phone (865) 312-6264

Other practice location 1

2317 W Emory Rd
Powell, TN 37849-3708
Phone (865) 312-6264

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
10191TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Orthodontics Orthodontics and Dentofacial Orthopedics CurrentSince Jul 7, 2024 Accepting new patients

Locations

1143 Oak Ridge Tpke
Ste 206
Oak Ridge, TN 37830
Phone (865) 312-6264

Organizations & group practices 1

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": "1155513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1587945600000",
    "number": "1902819618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1143 OAK RIDGE TPKE STE 206",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306482",
            "telephone_number": "865-312-6264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1143 OAK RIDGE TPKE STE 206",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378306482",
            "telephone_number": "865-312-6264"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2317 W Emory Rd",
            "address_purpose": "LOCATION",
            "city": "Powell",
            "state": "TN",
            "postal_code": "378493708",
            "country_code": "US",
            "telephone_number": "865-312-6264",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TRISLER",
        "first_name": "JUSTIN",
        "middle_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-14",
        "last_updated": "2020-04-27",
        "certification_date": "2020-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "10191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; 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.