Fady Barsoum, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

063469 Issued in NY

Practice address

3500 Sheridan Dr
Amherst, NY 14226-1548

Phone

(716) 508-4547

NPI assigned

May 16, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1652659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1696982400000",
    "number": "1033856703",
    "addresses": [
        {
            "country_code": "CA",
            "country_name": "Canada",
            "address_purpose": "MAILING",
            "address_type": "FGN",
            "address_1": "1100 TUESMAN WAY",
            "city": "OAKVILLE",
            "state": "ONTARIO",
            "postal_code": "L6H7M8"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 SHERIDAN DR",
            "city": "AMHERST",
            "state": "NY",
            "postal_code": "142261548",
            "telephone_number": "716-508-4547"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1000 Asylum Ave",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "CT",
            "postal_code": "061051770",
            "country_code": "US",
            "telephone_number": "860-714-4995",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BARSOUM",
        "first_name": "FADY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-05-16",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "063469",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jared C Barlow, MD
• Tinisha Monique Barnes, LPN
• Leslie Gail Barr, LCSW-R
• Samantha Barrett, PHARMD
• Heather Ann Barrick, M.S. CCC-SLP
• Matthew F Bartels, MD
• Vernice Bates, M.D.
• Ellen B Battista, NP
• Kimberly Bauer
• Michael Bauer

• Dentist in Amherst, NY
• Providers in Amherst, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; 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.