MILLIE DEAN RUSSELL (NPI# 1649502006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649502006 |
| Entity Type | Individual |
| Full Name | MILLIE DEAN RUSSELL |
| Credential | D.D.S. |
| Practice Address |
12058 San Jose Blvd #102 Jacksonville FL 32223-8666 |
| Practice Telephone | 9048803131 |
| Practice Fax Number | 9048803169 |
| Mailing Telephone | 9048803131 |
| Mailing Fax Number | 9048803169 |
| Enumeration Date | 2010-02-09 |
| Last Update Date | 2011-09-21 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | DS13804 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154986032 | Millie D Russell | Case Manager/Care Coordinator | 2005 Mclain St, Newport, AR 72112-3662 | 2019-05-06 |
| Street Address |
12058 SAN JOSE BLVD #102 |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32223-8666 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730182940 | Lynda R. Mance | Social Worker | 12058 San Jose Blvd, Suite 703, Jacksonville, FL 32223-8666 | 2005-05-23 |
| 1992298921 | Christina R Lee | Social Worker | 12058 San Jose Blvd, Jacksonville, FL 32223-8666 | 2018-06-13 |
| 1114266731 | Christan Bennett Brooks | Social Worker | 12058 San Jose Blvd, Ste 104, Jacksonville, FL 32223-8669 | 2013-02-01 |
| 1164651220 | Nancy Ann Busch | Social Worker | 12058 San Jose Blvd, Ste 703, Jacksonville, FL 32223-8666 | 2009-07-10 |
| 1922288364 | Krantz Dental Care, P.a. | Dentist | 12058 San Jose Blvd, Suite 102, Jacksonville, FL 32223-8666 | 2007-11-13 |
| 1811187271 | Mandarin Counseling Inc | Social Worker | 12058 San Jose Blvd, Ste 703, Jacksonville, FL 32223-8666 | 2007-07-31 |
| 1780736983 | Jacqueline Boudreau Viola | Social Worker | 12058 San Jose Blvd, Suite 703, Jacksonville, FL 32223-8666 | 2007-01-17 |
| 1356455000 | Luis E. Quinones, Md, Pa | Psychiatry & Neurology | 12058 San Jose Blvd, Suite 903, Jacksonville, FL 32223-1842 | 2006-08-19 |
| 1871509810 | Rosalind Ann Heller-slevin | Nurse Practitioner | 12058 San Jose Blvd, Suite1003, Jacksonville, FL 32223-8666 | 2006-07-31 |
| 1851338818 | Luis E. Quinones | Psychiatry & Neurology | 12058 San Jose Blvd, Suite 903, Jacksonville, FL 32223-1842 | 2006-05-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679103600 | Karen Gabriela Alexander | Dietitian, Registered | Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 | 2020-01-17 |
| 1891250049 | Thalia L Honea | Occupational Therapist | 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 | 2019-02-01 |
| 1447758289 | Stephanie Ann Murphy | Marriage & Family Therapist | 11543 Halethorpe Drive, Jacksonville, FL 32223 | 2018-01-26 |
| 1861948481 | Nicole Gay | Developmental Therapist | 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 | 2016-09-01 |
| 1740694439 | Robyn K Mizelle | Behavioral Analyst | 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 | 2014-06-20 |
| 1184038010 | Kelli Anne Cabrera | Occupational Therapist | 12350 San Jose Blvd, Jacksonville, FL 32223 | 2014-06-18 |
| 1891031910 | Mandarin Family Medicine, P.a. | Preferred Provider Organization | 12276-210 San Jose Blvd, Jacksonville, FL 32223 | 2012-12-18 |
| 1114201811 | Darshana Choksi | Pharmacist | 3663 Marbon Rd, Jacksonville, FL 32223 | 2011-09-30 |
| 1346539988 | Harris Wilcox and Donovan Pa | Optometrist | 11790 San Jose Bl, Jacksonville, FL 32223 | 2011-04-05 |
| 1740517796 | Beth A. Kelley | Occupational Therapist | 2640 Scott Mill Dr, Jacksonville, FL 32223 | 2009-11-12 |
| Find all providers in zip 32223 | ||||
| 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 |
|---|---|---|---|---|
| 1902419864 | Andre M Fang | Dentist | 6801 Roosevelt Blvd, Jacksonville, FL 32212-1192 | 2020-08-28 |
| 1952911752 | Jeff Woohyeok Chang | Dentist | 964 Ajax Street, Jacksonville, FL 32212 | 2020-08-06 |
| 1093323479 | Britney Marie Cruz | Dentist | 1280 Western Blvd Unit 200, Jacksonville, NC 28546-7658 | 2020-07-21 |
| 1083238786 | Sleep Better Solutions LLC | Dentist | 4215 Southpoint Blvd Ste 240, Jacksonville, FL 32216-0932 | 2020-05-29 |
| 1114550258 | James Moran | Dentist | 7990 Baymeadows Rd E # 718, Jacksonville, FL 32256-2961 | 2020-02-18 |
| 1265075329 | Latoya Goins | Dentist | 1280 Western Blvd, Jacksonville, NC 28546-6653 | 2019-10-22 |
| 1437706462 | Stephanie Marquez | Dentist | 751 Oak St Ste 601, Jacksonville, FL 32204-3373 | 2019-08-23 |
| 1831751064 | Rachel Marie Schloth | Dentist | 12086 Fort Caroline Rd Ste 105, Jacksonville, FL 32225-2688 | 2019-07-09 |
| 1598324113 | Dhaval Yogeshkumar Shah | Dentist | 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 | 2019-06-07 |
| 1235796954 | Carolina Garcia | Dentist | 790 Skymarks Dr Ste 109, Jacksonville, FL 32218-7267 | 2019-05-29 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32223 |
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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.