Russell Sandman, DMD, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

0515411 Issued in NY

Practice address

17331 Jamaica Ave
Jamaica, NY 11432-5523

Phone

(718) 291-4441

NPI assigned

Jan 30, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023154341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 W 58TH ST APT 17D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100192509",
            "telephone_number": "646-405-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17331 JAMAICA AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114325523",
            "telephone_number": "718-291-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANDMAN",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NY",
            "license": "0515411",
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NJ",
            "license": "22DI02309200",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02778912",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sebastian G Sanders, LPN
• Elisabeth Sanderson
• Naomi C. Sandgren, M. S., TSHH
• Jasmine Kaur Sandhu, MD
• Tejbir Singh Sandhu, PT
• George Sandor
• Kelly Michelle Sandoval
• Kayla Sanes, MSW
• Emma Sanger-Johnson, CNM
• Wiroon Sangsiraprapha, M.D.

• Orthodontics and Dentofacial Orthopedics Dentistry in Jamaica, NY
• Providers in Jamaica, NY by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.