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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. HEDLEY RAKUSIN
NPI 1427053040
Dentist - Endodontics in Dallas, TX

Active since June 20, 2005Opted out of Medicare · through Mar 7, 2028
11910 GREENVILLE AVE, STE 110, DALLAS, TX 75243(972) 644-1162(972) 783-6660 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Dr. Hedley Rakusin NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. HEDLEY RAKUSIN (NPI 1427053040) is an individual endodontics provider in Dallas, Texas, licensed in Texas (14886) and active in the NPI registry since June 2005. He has opted out of Medicare through March 7, 2028 and remains eligible to order and refer.

NPPES Registry Identity

NPI1427053040
Entity TypeIndividualMale
Primary Taxonomy1223E0200X
Provider Legal NameDR. HEDLEY RAKUSIN
Location Address11910 GREENVILLE AVE, STE 110Dallas, TX 75243-3564
Mailing Address11910 Greenville Ave, Ste 110Dallas, TX 75243-3564 · (972) 644-1162 · Fax (972) 783-6660
Phone(972) 644-1162
Fax(972) 783-6660
Sole ProprietorNo
Enumeration DateJune 20, 2005
Last NPPES UpdateJuly 13, 2026
✔ NPI 1427053040 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers
Taxonomy Code1223E0200X
License✔ Licensed in TX · 14886
Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

11910 GREENVILLE AVE, Dallas, TX 75243
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Hedley Rakusin has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from March 7, 2018 through March 7, 2028.

Opt-Out Effective DateMarch 7, 2018
Opt-Out In Effect ThroughMarch 7, 2028Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 75243 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.19 typical visit price
range $57.18 – $172.86
Typical copayment $22.04 (range $14.29 – $43.21)
Most-billed visit code 99203
Established Patient
$71.28 typical visit price
range $18.48 – $141.20
Typical copayment $17.82 (range $4.62 – $35.30)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. AMBREEN FEROZ ALI NADEEM PA-C
Physician Assistant
11910 GREENVILLE AVE, 500
DALLAS, TX 75243
Dallas County (214) 343-0058
ALBERT M JOWID D.D.S.
Dentist (Endodontics)
11910 GREENVILLE AVE, SUITE 110
DALLAS, TX 75243
Dallas County (972) 644-1162
RAQUEL LOPEZ PT
Physical Therapist
11910 GREENVILLE AVE, SUITE 500
DALLAS, TX 75243
Dallas County (214) 572-1124
CHRISTINE L HART CRNA
Nurse Anesthetist, Certified Registered
11910 GREENVILLE AVE, SUITE 650
DALLAS, TX 75243
Dallas County (214) 373-9092
PRIMACARE MEDICAL CENTERS
Family Medicine
11910 GREENVILLE AVE, SUITE 500
DALLAS, TX 75243
Dallas County (214) 572-1124
CHARLES GRAVELY PA
Physician Assistant (Medical)
11910 GREENVILLE AVE, SUITE 500
DALLAS, TX 75243
Dallas County (214) 572-1124
DR. HEMA HARIDAS M.D.
Family Medicine
11910 GREENVILLE AVE, SUITE 500
DALLAS, TX 75243
Dallas County (217) 572-1124
BINTAY JAFRI MD
Family Medicine
11910 GREENVILLE AVE, SUITE 500
DALLAS, TX 75243
Dallas County (214) 572-1124

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Hedley Rakusin's NPI number?

The NPI number for Hedley Rakusin is 1427053040. It was assigned to this individual provider in the NPPES registry on June 20, 2005.

Where is Hedley Rakusin located?

Hedley Rakusin practices at 11910 Greenville Ave Ste 110, Dallas, TX 75243. The listed phone number is (972) 644-1162.

What is Hedley Rakusin's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Hedley Rakusin enrolled in Medicare?

No. Hedley Rakusin has opted out of Medicare through March 7, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Hedley Rakusin was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.