Dominic Jacob Dirusso, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

38883 Issued in TX

Practice address

1450 Long Prairie Rd
Ste 160
Flower Mound, TX 75028

Phone

(469) 293-2220

NPI assigned

Dec 30, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

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": "1672358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1518670959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 CREST VIEW DR",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750061609",
            "telephone_number": "972-567-4830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 LONG PRAIRIE RD",
            "address_2": "STE 160",
            "city": "FLOWER MOUND",
            "state": "TX",
            "postal_code": "75028",
            "telephone_number": "469-293-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DIRUSSO",
        "first_name": "DOMINIC",
        "middle_name": "JACOB",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-12-30",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "38883",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kent Farr Dickson, M.D.
• Monique M Diebels, PT, DPT
• Joseph Alexander Difrancesco
• Maryanne Harrington Dimak, D.C.
• Regina K Dimbo, MD
• Zachary Kevin Dixon
• DNP Health Net, LLC
• Christopher Dockins
• Doctors Urgent Care - Flower Mound PLLC
• Shelley Dorsey

• General Practice Dentistry in Flower Mound, TX
• Providers in Flower Mound, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2022; 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.