DR. RUSSELL A WICKS (NPI# 1841372257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841372257 |
| Entity Type | Individual |
| Full Name | DR. RUSSELL A WICKS |
| Credential | DDS |
| Practice Address |
910 Madison Ave Ste 608 Memphis TN 38163-0001 |
| Practice Telephone | 9014486476 |
| Practice Fax Number | 9014481390 |
| Mailing Telephone | 9014486476 |
| Mailing Fax Number | 9014481390 |
| Enumeration Date | 2006-10-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3320 | TN | Dental Providers |
| Street Address |
910 MADISON AVE STE 608 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38163-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013905165 | Isaac Fordjour | Dentist | 910 Madison Ave, Suite 710, Memphis, TN 38103-3403 | 2005-10-12 |
| 1346736857 | Hisham Neyazi Abu Farsak | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Memphis, TN 38103-3403 | 2018-07-09 |
| 1023506607 | Veronica Easton | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Memphis, TN 38103 | 2018-04-29 |
| 1386172773 | David Allen Cooper | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Memphis, TN 38103-3403 | 2017-05-30 |
| 1104352293 | University of Tennessee Health Science Center | General Acute Care Hospital | 910 Madison Ave, Ste 1031, Memphis, TN 38103-3403 | 2017-05-10 |
| 1619320868 | Muhammad Hassaan Shahid | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Memphis, TN 38103-3403 | 2016-07-22 |
| 1427403278 | Xiangxia Liu | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Suite 315, Memphis, TN 38103-3403 | 2016-04-29 |
| 1619331220 | Patrick Probst | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Suite 409, Memphis, TN 38103-3403 | 2016-04-09 |
| 1033598248 | Steven D Kozusko | Plastic Surgery | 910 Madison Ave, Memphis, TN 38103-3403 | 2015-05-20 |
| 1588042675 | Joseph Vito Russo | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, Suite 1031, Memphis, TN 38103-3403 | 2015-05-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367537 | Stacie Nicole Yocom | Pediatrics | 853 Jefferson Ave Route E206, Memphis, TN 38163 | 2018-12-06 |
| 1639651052 | Angela Renae Haynes | Dental Hygienist | 875 Union Ave Dunn Dental Bldg C 517, Memphis, TN 38163 | 2018-09-01 |
| 1700362613 | Ibrahim Ortanca | Student in an Organized Health Care Education/Training Program | University of Tennessee 920 Madison Avenue, Suite 447 - Office of Graduate Medical Education, Memphis, TN 38163 | 2018-07-13 |
| 1619469103 | Julia Christine Cook | Student in an Organized Health Care Education/Training Program | University of Tennesee, 920 Madison Ave, Suite 447, Memphis, TN 38163 | 2018-05-31 |
| 1104359058 | Malik Fakhar | Student in an Organized Health Care Education/Training Program | 960 Madison Ave, 447, Memphis, TN 38163 | 2017-04-07 |
| 1215319322 | Yousef Abdel-aziz | Student in an Organized Health Care Education/Training Program | 956 Court Avenue Suite G310b, Memphis, TN 38163 | 2015-06-25 |
| 1770963746 | Ayman Al Dayeh | Dentist | 875 Union Ave, S312, Department of Orthodontics, Memphis, TN 38163 | 2015-06-04 |
| 1952789430 | Mark Iltis | Student in an Organized Health Care Education/Training Program | 910 Madison Ave, University of Tennessee, 1031, Memphis, TN 38163 | 2015-05-15 |
| 1700129780 | Mohammad Elballat | Student in an Organized Health Care Education/Training Program | 956 Court Ave Suite H314a, Memphis, TN 38163 | 2013-03-28 |
| 1932468204 | Evan Neal Paul | Student in an Organized Health Care Education/Training Program | 910 Madison Avenue, Suite 1031, Memphis, TN 38163 | 2012-05-08 |
| Find all providers in zip 38163 | ||||
| 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 |
|---|---|---|---|---|
| 1669016796 | John Jafarian | Dentist | Department of Periodontology 875 Union Avenue, Memphis, TN 38163-0001 | 2019-11-01 |
| 1689221152 | Dental Sleep Solutions Memphis Pllc | Dentist | 6389 N Quail Hollow Rd Ste 202, Memphis, TN 38120-1427 | 2019-08-20 |
| 1811540644 | Jane Nathanielle Moore | Dentist | 875 Union Ave Dunn Bldg Rm 502c, Memphis, TN 38163-0001 | 2019-07-21 |
| 1972096998 | Binal Jagadish Patel | Dentist | 113 Harbor Town Sq Ste 203, Memphis, TN 38103-8890 | 2018-06-13 |
| 1952894909 | Richard Anthony Law | Dentist | 875 Union Ave Dept of Orthodontics, Memphis, TN 38163-0001 | 2018-06-13 |
| 1497283691 | David Calvin Harris | Dentist | 6425 N Quail Hollow Rd Ste 101, Memphis, TN 38120-1438 | 2017-06-01 |
| 1427581057 | Ashley Hutchison | Dentist | 70 River Heights Dr Apt 304, Memphis, TN 38103-6970 | 2017-04-10 |
| 1790238533 | Fnu Sufia Kazima | Dentist | 3068 Covington Pike Ste 2, Memphis, TN 38128-5001 | 2016-07-28 |
| 1972958288 | Paul N. Gregory Jr. | Dentist | Univ of Tn College of Dentistry, 875 Union Ave., Memphis, TN 38163-0001 | 2016-04-25 |
| 1184083420 | Dove Family Dentistry - Bennington Pllc | Dentist | 5144 Riverdale Rd Ste 106, Memphis, TN 38141-0271 | 2016-02-15 |
| Find all providers in MEMPHIS | ||||
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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.