RUSSELL DENTAL GROUP, P.C. (NPI# 1942297643) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942297643 |
| Entity Type | Organization |
| Organization Name | RUSSELL DENTAL GROUP, P.C. |
| Practice Address |
130 Peachtree Plz Brownsville TN 38012-2500 |
| Practice Telephone | 7317722107 |
| Mailing Telephone | 7317722107 |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. THOMAS DUCKWORTH RUSSELL III (CORPORATION PRESIDENT, DENTIST) |
| Authorized Official Telephone | 7317722107 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223G0001X |
Dentist Specialization: General Practice |
7764 | TN | Dental Providers |
| N | 1223G0001X |
Dentist Specialization: General Practice |
6983 | TN | Dental Providers |
| Y | 1223G0001X |
Dentist Specialization: General Practice |
2338 | TN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | TENNCARE | 014423 | 01 |
| Street Address |
130 PEACHTREE PLZ |
| City | BROWNSVILLE |
| State | TN |
| Zip Code | 38012-2500 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760565642 | Thomas Duckworth Russell IIi | Dentist | 130 Peachtree Plz, Brownsville, TN 38012-2500 | 2006-10-23 |
| 1144303025 | Thomas Duckworth Russell Iv | Dentist | 130 Peachtree Plz, Brownsville, TN 38012-2500 | 2006-10-23 |
| 1790868685 | Andrew David Russell | Dentist | 130 Peachtree Plz, Brownsville, TN 38012-2500 | 2006-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598309213 | Henrietta Butler-shaw | Technician | 43 Autumn Dr., Brownsville, TN 38012 | 2019-11-06 |
| 1083711535 | Jaime Montoya Chavez | Legal Medicine | Box 291, Brownsville, TN 38012 | 2006-09-19 |
| 1083628432 | Bernasue Valerie Mcelrath | Chiropractor | 37 S Wilson Ave, Brownsville, TN 38012 | 2006-07-28 |
| 1427094655 | Gary Dean Pettigrew | Pharmacist | 2288 N Washington Ave, Quality Drug Company, Brownsville, TN 38012 | 2006-06-22 |
| 1184674590 | Jason Lowell Smothers | Optometrist | 1100 S Dupree Ave, Brownsville, TN 38012 | 2006-05-10 |
| 1972568749 | Crestview Health Care and Rehabilitation Inc | Nursing Facility/Intermediate Care Facility | 704 Dupree Rd, Brownsville, TN 38012 | 2006-04-17 |
| 1003302951 | Faith Family Medical Clinic, LLC | Nurse Practitioner | 511 E Main St, Brownsville, TN 38012 | 2018-07-03 |
| 1780073213 | Robert Franklin Callery | Registered Nurse | 511 E Main St, Brownsville, TN 38012 | 2015-01-21 |
| 1184055345 | Ray Wakefield | Nurse Practitioner | 2290 N Washington Ave, Brownsville, TN 38012 | 2013-12-12 |
| 1821148073 | State of Tennessee | Public Health or Welfare | 950 East Main Street, Brownsville, TN 38012 | 2007-01-11 |
| Find all providers in zip 38012 | ||||
| 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 |
|---|---|---|---|---|
| 1538783287 | Tugraberk Usul | Dentist | 130 Simpson Rd, Brownsville, PA 15417-9625 | 2020-05-28 |
| 1427536853 | Shree Shanker Shrestha | Dentist | 2950 Southmost Boulevard #103, Brownsville, TX 78521-4787 | 2018-07-28 |
| 1386138170 | Chang Joo Lee | Dentist | 2950 Southmost Blvd, Suite 103, Brownsville, TX 78521 | 2018-06-15 |
| 1487185526 | Arcade Dental Pllc | Dentist | 146 Caribbean Dr, 103, Brownsville, TX 78520-3615 | 2017-03-21 |
| 1265986640 | Olga Ruby Salinas | Dentist | 1205 E Alton Gloor Blvd, Brownsville, TX 78526-3831 | 2016-08-15 |
| 1609242858 | Professional Dental Group, P.a. | Dentist | 1115 Professional Drive, Brownsville, TX 78520 | 2015-08-11 |
| 1336523364 | Vanesa G Clements Dds PC | Dentist | 2200 Boca Chica Blvd, #138, Brownsville, TX 78521-2212 | 2015-07-20 |
| 1609294172 | Melissa Uriegas | Dentist | 4920 N Expressway Ste E, Brownsville, TX 78526-4335 | 2014-04-02 |
| 1164763553 | River Hill Dental | Dentist | 1427 Ky Highway 259 N, Brownsville, KY 42210-9280 | 2013-03-08 |
| 1619239837 | Premier Dental Center | Dentist | 1203 E College St, Brownsville, TN 38012-1656 | 2012-06-13 |
| Find all providers in BROWNSVILLE | ||||
| City | BROWNSVILLE |
| Zip Code | 38012 |
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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.