Richard G. Russo, DMD

Primary specialty

Public Health DentistryTaxonomy code 1223D0001X

License

DN10829 Issued in FL

Practice address

832 W Central Blvd
Orlando, FL 32805-1809

Phone

(407) 836-2616

NPI assigned

Feb 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1170892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1063553774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2500 21ST ST NW APT 79",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338811275",
            "telephone_number": "863-299-7748"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "832 W CENTRAL BLVD",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328051809",
            "telephone_number": "407-836-2616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "RICHARD",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-08",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "FL",
            "license": "DN10829",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "072262600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "DN10829",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cristy L. Cox Russo, PH.D.
• Dynella Russo, FNP
• John E Russo, DMD
• Joseph William Russo, DNP, CPNP
• Kari B Russo, LMHC, MS
• Delaney Rust
• Kelsey J Rust, CRNA
• Sophia Grace Rustin, RBT
• Chelsea Michelle Rustum
• Leah Allison Rutberg

• Public Health Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• Public Health Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.