DR. RANDALL J RUSSELL (NPI# 1013170968) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1013170968 |
Entity Type | Individual |
Full Name | DR. RANDALL J RUSSELL |
Credential | D.D.S. |
Practice Address |
20971 E Smoky Hill Rd Suite 201 Centennial CO 80015-5186 |
Practice Telephone | 7208701451 |
Practice Fax Number | 7208701456 |
Mailing Telephone | 7208701451 |
Mailing Fax Number | 7208701456 |
Enumeration Date | 2008-07-09 |
Last Update Date | 2013-03-11 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DEN.00201913 | CO | Dental Providers |
N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1285171892 | Randall Shane Russell | Counselor | 158 Mcgehee Dr, Baton Rouge, LA 70815-5012 | 2017-01-21 |
Street Address |
20971 E SMOKY HILL RD SUITE 201 |
City | CENTENNIAL |
State | CO |
Zip Code | 80015-5186 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669481818 | Eric Bowen Tedstrom | Social Worker | 20971 E Smoky Hill Rd, Ste 215, Centennial, CO 80015-5186 | 2006-08-05 |
1366932824 | Nancy L Mickelson | Social Worker | 20971 E Smoky Hill Rd, Centennial, CO 80015-5186 | 2018-05-10 |
1841723897 | Will Bedford-sutro | Case Manager/Care Coordinator | 20971 E Smoky Hill Rd, Centennial, CO 80015-5186 | 2017-04-06 |
1912354812 | Advanced Periodontics & Implant Dentistry Pllc | Dentist | 20971 E Smoky Hill Rd, Ste 202, Centennial, CO 80015-5186 | 2016-05-20 |
1134518467 | Presken Family Care PC | Family Medicine | 20971 E Smoky Hill Rd, Suite 107, Centennial, CO 80015-5186 | 2015-01-09 |
1811238264 | Randall J Russell Dds PC | Clinic/Center | 20971 E Smoky Hill Rd, Suite 201, Centennial, CO 80015-5186 | 2013-03-11 |
1770848426 | Mary Elizabeth Mcclure | Social Worker | 20971 E Smoky Hill Rd, Centennial, CO 80015-5186 | 2012-07-09 |
1871881664 | Carlton J Floyd Dds Ms PC | Dentist | 20971 E Smoky Hill Rd, Suite #201, Centennial, CO 80015-5186 | 2011-07-14 |
1568625879 | Brent James Nielsen | Dentist | 20971 E Smoky Hill Rd, Ste #202, Centennial, CO 80015-5186 | 2008-07-07 |
1285812867 | Highline Center for Vision & Learning | Optometrist | 20971 E Smoky Hill Rd, Suite 106, Centennial, CO 80015-5186 | 2008-02-05 |
Find all providers in the same location |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679128326 | Heather Hartleroad | Counselor | 21699 E Quincy Ave Unit F, #352, Aurora, CO 80015 | 2019-08-08 |
1033602792 | 4abilities, LLC. | Non-emergency Medical Transport (VAN) | 5105 S Valdai Street, Aurora, CO 80015 | 2018-06-07 |
1952827719 | 1st Centennial Home Health LLP | Home Health | 5418 S Danube Way, Centennial, CO 80015 | 2017-08-14 |
1881132157 | 1st Allergy Asthma and Pediatrics Too, Inc. | Specialist | 15470 E Smoky Hill Road, Aurora, CO 80015 | 2017-02-07 |
1467909028 | Silver Touch Home Care | In Home Supportive Care | 21804 E. Lake Pl, Aurora, CO 80015 | 2016-09-01 |
1417302514 | Michelle Dinges | Dietitian, Registered | 5606 S Helena Ct, Centennial, CO 80015 | 2016-04-27 |
1043664907 | Gomgom Siregar | Home Health Aide | 5235 S Liverpool Way, Centennial, CO 80015 | 2016-04-18 |
1104280528 | Lloyd Reliford | Custodial Care Facility | 5556 S Jericho Way, Centennial, CO 80015 | 2016-04-12 |
1003279563 | Victoria Care Services | Respite Care | 17285 E Wagontrail Pkwy, Aurora, CO 80015 | 2016-04-01 |
1699130104 | Gina Michelle Fernandez | Physician Assistant | 14813 E Radcliff Pl, Aurora, CO 80015 | 2015-12-28 |
Find all providers in zip 80015 |
Taxonomy Code | 1223S0112X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Oral and Maxillofacial Surgery |
The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609174218 | Bryce Jay Darrell Williams | Dentist | 14000 East Arapahoe Road Suite #320, Centennial, CO 80112 | 2011-03-06 |
1811199920 | Advanced Oral & Maxillofacial Surgery | Dentist | 9094 E Mineral Ave., Suite 260, Centennial, CO 80112-7201 | 2007-06-01 |
1609974831 | Charles F. Wennogle | Dentist | 17715 E Jamison Ave, Centennial, CO 80016-1814 | 2006-09-20 |
1871881664 | Carlton J Floyd Dds Ms PC | Dentist | 20971 E Smoky Hill Rd, Suite #201, Centennial, CO 80015-5186 | 2011-07-14 |
1336322346 | Aaron T. Liddell | Dentist | 14000 E. Arapahoe Road, Suite 320, Centennial, CO 80112-4047 | 2007-12-12 |
1982727657 | Edward Marc Weideman | Dentist | 9094 E Mineral Ave, Suite 260, Centennial, CO 80112 | 2007-04-09 |
1184798290 | Carlton James Floyd | Dentist | 20971 E Smoky Hill Rd, Suite #201, Centennial, CO 80015-5186 | 2006-11-20 |
1437223419 | Thomas Stanley Michalik | Dentist | 9094 E. Mineral Ave., Suite 260, Centennial, CO 80112 | 2006-11-20 |
1538268917 | James Robert Lessig | Dentist | 9094 E Mineral Ave, Suite 260, Centennial, CO 80112 | 2006-09-21 |
1003925058 | Brandon Dean Schultz | Dentist | 15250 E Orchard Rd, Centennial, CO 80016 | 2006-08-30 |
Find all providers in CENTENNIAL |
City | CENTENNIAL |
Zip Code | 80015 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.