Individual provider Active NPI

Idris Hassuji

  • General Practice Dentistry
  • Dallas, TX
National Provider Identifier
1730973249
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42832 Issued in TX
Practice address
9323 Garland Rd Ste 105
Dallas, TX 75218-3675
Phone
(214) 217-4136
NPI assigned
Apr 8, 2025
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 42832 TX Primary

Addresses

Primary practice location

9323 Garland Rd Ste 105
Dallas, TX 75218-3675

Mailing address

22419 Hillside Ave Apt 1
Queens Village, NY 11427-2002
Phone (646) 472-9896

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42832TXMDSpeech-Language Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Dentists of White Rock, PC Multi-Specialty PastSince Nov 17, 2019 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1744070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1730973249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22419 HILLSIDE AVE APT 1",
            "city": "QUEENS VILLAGE",
            "state": "NY",
            "postal_code": "114272002",
            "telephone_number": "646-472-9896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9323 GARLAND RD STE 105",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752183675",
            "telephone_number": "214-217-4136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HASSUJI",
        "first_name": "IDRIS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-04-08",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "42832",
            "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 Sep 15, 2026; 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.