Organization Active NPI

Fusion Children'S Dentistry PLLC

  • Pediatric Dentistry
  • Dallas, TX
National Provider Identifier
1518548783
Registry record updated Jan 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
Legal business name
FUSION CHILDREN'S DENTISTRY PLLC
Practice address
19200 Preston Rd Ste 120
Dallas, TX 75252-2450
Phone
(972) 666-4949
Fax
(972) 666-4944
NPI assigned
Apr 19, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 11, 2025

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

Authorized official

Name
Dr. Niloofar Khalesseh, DDS, MSNPI 1952693970
Title
Owner
Phone
(310) 666-6071

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0221X Primary

Addresses

Primary practice location

19200 Preston Rd Ste 120
Dallas, TX 75252-2450

Mailing address

19200 Preston Rd
Dallas, TX 75252-2450

National Provider Directory

National Provider Directory

Locations

19200 Preston Rd
Dallas, TX 75252
Phone (312) 479-1449

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736553600000",
    "number": "1518548783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19200 PRESTON RD",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752522450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19200 PRESTON RD STE 120",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752522450",
            "telephone_number": "972-666-4949",
            "fax_number": "972-666-4944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FUSION CHILDREN'S DENTISTRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-19",
        "last_updated": "2025-01-11",
        "certification_date": "2025-01-11",
        "status": "A",
        "authorized_official_last_name": "KHALESSEH",
        "authorized_official_first_name": "NILOOFAR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "310-666-6071",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2025; 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.