Marjan Rusta, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

43392 Issued in CA

Practice address

1313 Gilman St Ste a
Berkeley, CA 94706-2431

Phone

(510) 526-7546

Fax

(510) 526-1027

NPI assigned

May 14, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Marjan Rusta DDS Inc

  • General Practice Dentistry
  • Berkeley, CA
  • NPI 1164246864
  NPD Authorized official

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053526749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "971 VENTURA AVE",
            "city": "ALBANY",
            "state": "CA",
            "postal_code": "947072541",
            "telephone_number": "510-526-7546",
            "fax_number": "510-526-1027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 GILMAN ST STE A",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947062431",
            "telephone_number": "510-526-7546",
            "fax_number": "510-526-1027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSTA",
        "first_name": "MARJAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "43392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Jayne Russell, PSYD
• Carole Russell, N.P.
• Kevin Russell, L.AC.
• Irene Russo, MS PSYCHOLOGY
• Vincent Russo, CAADAC
• Taly Rutenberg, LCSW
• Joshua Jacob Rutt
• Matthew Rutzi
• Gabriella Rochelle Ruzin
• Ryan L. Horn, D.D.S. and Barron K. Hong, D.M.D., M.S., a Partnership

• General Practice Dentistry in Berkeley, CA
• Providers in Berkeley, CA by specialty
• General Practice Dentistry in California

• 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.