NPIMap

Organization Active NPI

Legacy Hill Dentistry

Doing business as Ricky Dale Russell, DDS

  • General Practice Dentistry
  • Smyrna, TN
National Provider Identifier
1003151390
Registry record updated Nov 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
LEGACY HILL DENTISTRY
Doing business as
Ricky Dale Russell, DDS
Practice address
526 Legacy Dr
Smyrna, TN 37167-6750
Phone
(615) 459-8050
Fax
(615) 459-6023
NPI assigned
Nov 28, 2012
Last updated
Nov 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Ricky Dale Russell, DDSNPI 1407963622
Title
Owner
Phone
(615) 459-8050

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

526 Legacy Dr
Smyrna, TN 37167-6750

Mailing address

526 Legacy Dr
Smyrna, TN 37167-6750
Phone (615) 459-8050

Other names 1

  • Ricky Dale Russell, DDS Doing business as

National Provider Directory

National Provider Directory

Locations

526 Legacy Dr
Smyrna, TN 37167
Phone (615) 459-8050

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1354060800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1354060800000",
    "number": "1003151390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 LEGACY DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676750",
            "telephone_number": "615-459-8050",
            "fax_number": "615-459-6023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 LEGACY DR",
            "city": "SMYRNA",
            "state": "TN",
            "postal_code": "371676750",
            "telephone_number": "615-459-8050",
            "fax_number": "615-459-6023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LEGACY HILL DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-28",
        "last_updated": "2012-11-28",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "DALE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-459-8050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ricky Dale Russell, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Smyrna, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.