Fadi Kreisheh, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17865 Issued in MD

Practice address

21 E Padonia Rd
Lutherville, MD 21093-2306

Phone

(410) 913-5700

NPI assigned

Sep 25, 2020

Last updated

May 22, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Bel Air Dental Health, LLC

  dba Bel Air Dental Health and Implant Center

  • Dental Clinic/Center
  • Bel Air, MD
  • NPI 1295574051
  NPD Authorized official
• Kreisheh,, LLC

  dba Charm City Smiles

  • General Practice Dentistry
  • Lutherville Timonium, MD
  • NPI 1558970137
  NPD

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1508473349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 CROFTLEY RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210935802",
            "telephone_number": "773-986-6193"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 E PADONIA RD",
            "city": "LUTHERVILLE",
            "state": "MD",
            "postal_code": "210932306",
            "telephone_number": "410-913-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KREISHEH",
        "first_name": "FADI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-09-25",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019.032915",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.032915",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "17865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leo Israel Korotki, M.D.
• Jerome Kowalewski, PHD
• Ibikunle Olayemi Koya, MD
• Walter Ernest Kozachuk, M.D.
• Elizabeth R Kramer, M.AC., L.AC.
• Jane L Krimmel, LCSW-C
• Robert Kimball Kritzler, MD
• Deana Krizan
• Christine Mae Kuhlman, LCSW-C
• Oluwafoyinsayomi Fasanmi Kumoluyi, MD

• General Practice Dentistry in Lutherville, MD
• Providers in Lutherville, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2024; 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.