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TRENT ICHIUJI DDS
NPI 1255834602
Dentist - Oral and Maxillofacial Surgery in Saratoga Springs, NY

Active since March 12, 2018Opted out of Medicare · through Jul 21, 2027
4 CARE LN, SARATOGA SPRINGS, NY 12866(518) 583-4497 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Apr 5, 2021, Jun 5, 2020, Mar 12, 2018 (3 updates tracked since 2018).

About Trent Ichiuji Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TRENT ICHIUJI DDS (NPI 1255834602) is an individual oral and maxillofacial surgery provider in Saratoga Springs, New York, licensed in New York (064669) and active in the NPI registry since March 2018. He has opted out of Medicare through July 21, 2027 and maintains a secondary practice location in Bronx.

NPPES Registry Identity

NPI1255834602
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameTRENT ICHIUJICredential: DDS
Location Address4 CARE LNSaratoga Springs, NY 12866-8624
Mailing Address4 Care LnSaratoga Springs, NY 12866-8624 · (518) 583-4497 · Fax (518) 583-3779
Phone(518) 583-4497
Sole ProprietorYes
Enumeration DateMarch 12, 2018
Last NPPES UpdateAugust 21, 20253 updates tracked since enumeration
NPPES CertifiedAugust 21, 2025
✔ NPI 1255834602 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in NY · 064669
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
4 CARE LN, Saratoga Springs, NY 12866
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Secondary Practice Location 1

Location 1111 E 210th StBronx, NY 10467-2401 · Phone (718) 920-4321

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Trent Ichiuji Dds has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from July 21, 2025 through July 21, 2027.

Opt-Out Effective DateJuly 21, 2025
Opt-Out In Effect ThroughJuly 21, 2027Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. ROBERT DENNIS CARPENTER DMD
Dentist (Oral and Maxillofacial Pathology)
4 CARE LN
SARATOGA SPRINGS, NY 12866
Saratoga County (518) 583-4497
DR. LIONEL ANGELO BULFORD DDS
Dentist (Oral and Maxillofacial Surgery)
4 CARE LN
SARATOGA SPRINGS, NY 12866
Saratoga County (518) 583-4497
SARATOGA COUNTY ORAL & MAXILLOFACIAL SURGERY ASSOCIATES
Dentist (Oral and Maxillofacial Surgery)
4 CARE LN
SARATOGA SPRINGS, NY 12866
Saratoga County (518) 583-4497

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Trent Ichiuji's NPI number?

The NPI number for Trent Ichiuji is 1255834602. It was assigned to this individual provider in the NPPES registry on March 12, 2018.

Where is Trent Ichiuji located?

Trent Ichiuji practices at 4 Care Ln, Saratoga Springs, NY 12866. The listed phone number is (518) 583-4497.

What is Trent Ichiuji's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Trent Ichiuji enrolled in Medicare?

No. Trent Ichiuji has opted out of Medicare through July 21, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Trent Ichiuji accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas list Trent Ichiuji as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Trent Ichiuji was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.