MARK WILLIAM RUSSELL (NPI# 1831710771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831710771 |
| Entity Type | Individual |
| Full Name | MARK WILLIAM RUSSELL |
| Credential | DMD |
| Practice Address |
461 Western Blvd Ste 104 Jacksonville NC 28546-7637 |
| Mailing Address |
1951b Cambria Dr Greenville NC 27834-0094 |
| Practice Telephone | 9103462202 |
| Mailing Telephone | 9106388413 |
| Enumeration Date | 2020-05-01 |
| Last Update Date | 2020-06-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
11836 | NC | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1951b Cambria Dr, Greenville, NC 278340094 | 9106388413 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144752221 | Mark Russell | Social Worker | 475 Sykesville Troutville Rd, Punxsutawney, PA 15767-4367 | 2017-03-29 |
| 1154767267 | Mark Stephen Russell Jr. | Counselor | 3901 Airport Fwy Ste 107, Bedford, TX 76021-6117 | 2013-05-15 |
| 1437314366 | Mark William Russell | Community Health Worker | 108 Schooner Landing Dr, Edenton, NC 27932-8833 | 2008-07-21 |
| 1306867049 | Mark Duane Russell | Specialist/Technologist | 3950 Hollywood Rd Ste 140, Saint Joseph, MI 49085-9151 | 2006-07-21 |
| 1639137540 | Mark Russell | Internal Medicine | 13024 Hesperia Rd Ste 103, Victorville, CA 92395-8303 | 2006-05-02 |
| 1689671315 | Mark Dale Russell | Chiropractor | 5309 44th St, Lubbock, TX 79414-1321 | 2005-07-07 |
| 1154827756 | Mark Russell | Student in an Organized Health Care Education/Training Program | 2160 S 1st Ave, Maywood, IL 60153-3328 | 2018-04-03 |
| 1033654967 | Mark Russell | Pharmacist | 2920 Knoxville Center Dr, Knoxville, TN 37924-2013 | 2017-01-02 |
| 1477097392 | Mark Russell | Social Worker | 302 S Spring St, Tupelo, MS 38804-4853 | 2016-12-12 |
| 1134463870 | Mark Joseph Russell | Occupational Therapist | 275 East Main Street, Frankfort, KY 40621-0001 | 2012-11-19 |
| Street Address |
461 WESTERN BLVD STE 104 |
| City | JACKSONVILLE |
| State | NC |
| Zip Code | 28546-7637 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316578388 | Judylyn Hobson | Registered Nurse | Pride In North Carolina, LLC, 3886 Henderson Dr, Jacksonville, NC 28546 | 2020-01-29 |
| 1427694637 | Aaron Patrick Bettcher | Military Health Care Provider | 3rd Mrb Loop Rd, Camp Lejeune, NC 28546 | 2019-11-22 |
| 1962044289 | Levi Scott Marshall | Military Health Care Provider | Everett Creek Road, Building 612, Camp Lejeune, NC 28546 | 2019-10-09 |
| 1649826652 | Nicholas Otazo | Military Health Care Provider | 3rd Mrb 20073, Camp Lejeune, NC 28546 | 2019-08-15 |
| 1417519570 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 2001 Marlin Drive Unit 100, Jacksonville, NC 28546 | 2019-06-28 |
| 1023500212 | Josip Ninrodriguez | Military Health Care Provider | 3d Marine Raider Battaliom, Camp Lejeune, NC 28546 | 2018-06-04 |
| 1639661192 | Kenneth Lee Russell | Military Health Care Provider | 3d Marine Raider Battalion, Camp Lejeune, NC 28546 | 2018-05-31 |
| 1346730173 | Coastal Foot Center, LLC | Clinic/Center | 29 Office Park Dr Ste B, Jacksonville, NC 28546 | 2018-05-17 |
| 1578080271 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 380 Western Blvd, Jacksonville, NC 28546 | 2017-08-24 |
| 1144757493 | Darin Lee Peterson | Specialist/Technologist | G644 Camp Geiger, School of Infantry-east, Jacksonville, NC 28546 | 2017-05-17 |
| Find all providers in zip 28546 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962018424 | Sydney Fowler | Dentist | 12276 San Jose Blvd Ste 314, Jacksonville, FL 32223-8632 | 2020-09-21 |
| 1871106260 | Comfortable Care Dental Health Professionals, P.a. | Dentist | 4445 Town Center Pkwy, Jacksonville, FL 32246-8565 | 2020-08-26 |
| 1205476496 | Point Meadows Dental Center, Inc. | Dentist | 10915 Baymeadows Rd, #106, Jacksonville, FL 32256 | 2020-01-15 |
| 1659923118 | San Jose Aspen Pllc | Dentist | 10502 San Jose Blvd Ste B, Jacksonville, FL 32257-6209 | 2019-07-15 |
| 1326603176 | Evens Family Dental | Dentist | 13107 Atlantic Blvd, Jacksonville, FL 32225-7127 | 2019-05-07 |
| 1487123006 | Susan Prater Kudlats, D.m.d, P.a. | Dentist | 12620 Beach Blvd Ste 18, Jacksonville, FL 32246-7130 | 2018-11-14 |
| 1043792534 | Atlantic Dentistry Pa | Dentist | 13474 Atlantic Blvd Ste 109, Jacksonville, FL 32225-0100 | 2018-08-31 |
| 1447738620 | Argyle Dental Pllc | Dentist | 6001 Argyle Forest Blvd Ste 4, Jacksonville, FL 32244-6127 | 2018-07-31 |
| 1427534445 | Sandeep Chunduru | Dentist | 571 Yopp Rd Ste 308, Jacksonville, NC 28540-3683 | 2018-07-12 |
| 1669968905 | Micheline Baz Elbahri | Dentist | 8131 Baymeadows Cir W Ste 102, Jacksonville, FL 32256 | 2018-07-10 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 28546 |
Please comment or provide details below to improve the information on MARK WILLIAM RUSSELL.
| 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.