DR. NICHOLAS VITO RUSSO (NPI# 1063811297) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063811297 |
| Entity Type | Individual |
| Full Name | DR. NICHOLAS VITO RUSSO |
| Credential | D.D.S. |
| Practice Address |
12690 W North Ave Brookfield WI 53005-4636 |
| Practice Telephone | 2627843740 |
| Mailing Telephone | 2627843740 |
| Enumeration Date | 2014-08-13 |
| Last Update Date | 2016-02-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 1000994-15 | WI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134255672 | Nicholas Roy Russo | Dentist | 6754 W Beloit Rd, West Allis, WI 53219-2068 | 2007-02-27 |
| 1487282695 | Nicholas Anthony Russo | Student in an Organized Health Care Education/Training Program | 77 Goodell Street, Suite 550, Buffalo, NY 14203 | 2020-04-01 |
| 1174151930 | Nicholas Anthony Russo | Student in an Organized Health Care Education/Training Program | 30 Prospect Ave, Hackensack, NJ 07601-1915 | 2020-03-29 |
| 1679005649 | Nicholas John Russo | Student in an Organized Health Care Education/Training Program | 47 New Scotland Ave Dept Of, Albany, NY 12208-3412 | 2017-03-29 |
| 1407164197 | Nicholas J. Russo | Dentist | 300 Foulk Rd Ste 101, Wilmington, DE 19803-3819 | 2010-09-16 |
| 1295900512 | Nicholas A Russo | Anesthesiology | 9500 Euclid Ave, Cleveland Clinic Foundation, Cleveland, OH 44195-0001 | 2008-04-28 |
| Street Address |
12690 W NORTH AVE |
| City | BROOKFIELD |
| State | WI |
| Zip Code | 53005-4636 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427002211 | Eric D Seybold | Psychologist | 12690 W North Ave, Brookfield, WI 53005-4636 | 2006-05-19 |
| 1376903047 | Maria Byrd | Counselor | 12690 W North Ave, Brookfield, WI 53005-4636 | 2016-02-24 |
| 1134502743 | Sarah Hoerl | Counselor | 12690 W North Ave, Brookfield, WI 53005-4636 | 2015-06-30 |
| 1811378920 | Elizabeth Anne Sawyer | Counselor | 12690 W North Ave, Brookfield, WI 53005-4636 | 2015-06-15 |
| 1538557848 | Russo Dental LLC | Dentist | 12690 W North Ave, Brookfield, WI 53005-4636 | 2015-01-08 |
| 1073891370 | Elizabeth W Baritt | Counselor | 12690 W North Ave, Brookfield, WI 53005-4636 | 2011-08-03 |
| 1780988667 | Siobhan Megan Mccullough Petrie | Counselor | 12690 W North Ave, Building C, Brookfield, WI 53005-4636 | 2011-01-06 |
| 1396985958 | Mary Sheila Briggs | Social Worker | 12690 W North Ave, Brookfield, WI 53005-4636 | 2009-02-23 |
| 1326286139 | Laura Ann Floyd | Social Worker | 12690 W North Ave, Building C, Brookfield, WI 53005-4636 | 2009-02-02 |
| 1598943763 | Deann Frey | Counselor | 12690 W North Ave, Brookfield, WI 53005-4636 | 2008-02-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154937621 | Nsk Precision Healing & Wellness | Acupuncturist | 17040 W. Greenfield Ave #6, Brookfield, WI 53005 | 2020-09-21 |
| 1033772124 | Dbt Consultants LLC | Social Worker | 200 S. Executive Drive, Ste. 101, Brookfield, WI 53005 | 2019-04-15 |
| 1780142588 | Ashley Wing | Registered Nurse | 405 Bishops Way, Apt 555, Brookfield, WI 53005 | 2019-03-11 |
| 1407370398 | Tombolo, LLC | Clinic/Center | 12545 W. Burleigh Rd., Suite 10, Brookfield, WI 53005 | 2017-08-01 |
| 1720509045 | Rss William Conner LLC | Dentist | 15455 W Bluemound Rd Ste 250, Brookfield, WI 53005 | 2017-06-28 |
| 1669926598 | Mackenzie Rondeau | Physical Therapist | 1905 N Calhoun Rd Ste 105, Brookfield, WI 53005 | 2016-08-09 |
| 1699159319 | Charles Alan Kass | Dentist | 12720 W. North Avenue, Brookfield, WI 53005 | 2015-07-13 |
| 1164804274 | Mary-catherine Nimphius | Counselor | 250 S. Sunny Slope Rd, #128, Brookfield, WI 53005 | 2015-06-25 |
| 1528447034 | Weighless Md, LLC | Dietitian, Registered | 14960 W. Greenfield Ave Suite 104, Brookfield, WI 53005 | 2015-05-29 |
| 1366837346 | Maegan Michelle Cook | Dentist | 13780 W Greenfield Ave Ste 780, Brookfield, WI 53005 | 2015-04-06 |
| Find all providers in zip 53005 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215570528 | Grace Kim Tosi | Dentist | 15375 W Bluemound Rd Ste 150, Brookfield, WI 53005-4008 | 2019-10-21 |
| 1073073151 | Miranda Marie Brown | Dentist | 17600 W Capitol Dr, Brookfield, WI 53045-2003 | 2019-03-23 |
| 1003254947 | Peter A Drahos Dds PC | Dentist | 9118 Ogden Ave Unit B, Brookfield, IL 60513-1974 | 2013-06-13 |
| 1689011991 | Adam Jon Meinhardt | Dentist | 3930 N Brookfield Rd, Suite A, Brookfield, WI 53045-1960 | 2013-05-28 |
| 1689994824 | Samantha Taylor Cox | Dentist | 12455 W Capitol Dr, Unit E, Brookfield, WI 53005-2461 | 2010-06-10 |
| 1306002258 | Keith E Post | Dentist | 15655 W North Ave, #102, Brookfield, WI 53005-4422 | 2008-07-30 |
| 1720244759 | Saadallah Jabri | Dentist | 9144 Broadway Ave, Brookfield, IL 60513-1304 | 2008-07-30 |
| 1437339421 | Alan John Stover | Dentist | 16475 Tia Ct, Brookfield, WI 53005-1311 | 2007-11-07 |
| 1407043417 | Thomas Andersen | Dentist | 14265 Sunrise Ave, Brookfield, WI 53005-1122 | 2007-10-03 |
| 1053514471 | Robert Allen Jazgar I | Dentist | 2355 Tilton Ct, Brookfield, WI 53045-4282 | 2007-06-06 |
| Find all providers in BROOKFIELD | ||||
| City | BROOKFIELD |
| Zip Code | 53005 |
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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.