Active NPI
Carl E Fusco-Gessick, DDS
- Pediatric Dentistry
- Buffalo, NY
National Provider Identifier
1801389689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 061260
- Practice address
- 114 Squire Hall
Buffalo, NY 14214-8006 - Phone
- (716) 829-3717
- Fax
- (716) 829-3895
- NPI assigned
- Jun 7, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 061260 | NY | Primary |
Addresses
Primary practice location
114 Squire Hall
Buffalo, NY 14214-8006
Mailing address
114 Squire Hall
Buffalo, NY 14214-8006
Phone (716) 829-3717
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
| License | State | Type | Specialty |
|---|---|---|---|
| 061260 | NY | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1528329600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1600214400000",
"number": "1801389689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "114 SQUIRE HALL",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142148006",
"telephone_number": "716-829-3717",
"fax_number": "716-829-3895"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "114 SQUIRE HALL",
"city": "BUFFALO",
"state": "NY",
"postal_code": "142148006",
"telephone_number": "716-829-3717",
"fax_number": "716-829-3895"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FUSCO-GESSICK",
"first_name": "CARL",
"middle_name": "E",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-06-07",
"last_updated": "2020-09-16",
"certification_date": "2020-09-14",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "NY",
"license": "061260",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buffalo, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.