Ashley Russell, DMD

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10976 Issued in TN

Practice address

1103 Callahan Dr
Knoxville, TN 37912-1310

Phone

(865) 859-0355

NPI assigned

Jun 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• East Tennessee Pediatric Dentistry at Oak Ridgepllc.

  • Pediatric Dentistry
  • Oak Ridge, TN
  • NPI 1568952505
  NPD (past)
• East Tennessee Pediatric Dentistry PLLC

  • Pediatric Dentistry
  • Knoxville, TN
  • NPI 1609211267
  NPD (past)
• Care for Kids Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Kingwood, TX
  • NPI 1548713688
  NPD (past)

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564272000000",
    "number": "1083029086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1329 FOREST BROOK RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379198214",
            "telephone_number": "251-656-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 CALLAHAN DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379121310",
            "telephone_number": "865-859-0355"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Care for Kids Pediatric Dentistry",
            "address_2": "24510 Eastex Fwy, Suite 110",
            "address_purpose": "LOCATION",
            "city": "Kingwood",
            "state": "TX",
            "postal_code": "77339",
            "country_code": "US",
            "telephone_number": "281-608-7535",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "500 Oak Ridge Tpke",
            "address_purpose": "LOCATION",
            "city": "Oak Ridge",
            "state": "TN",
            "postal_code": "378307109",
            "country_code": "US",
            "telephone_number": "865-859-0357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-27",
        "last_updated": "2019-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "6110",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AL",
            "license": "6110",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "33891",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "10976",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caroline Russe, LCSW
• Lauren Alexis Russell-Moore, B.S.
• Allysa Russell, MA
• Andrew Russell, LPC
• Anne Elise Russell
• Buffy Tenille Russell
• Carabeth West Russell, M.D.
• Carri Russell, BSW
• Cassandra Russell
• Courtney Russell, PHARMD

• Pediatric Dentistry in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Pediatric Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.