Organization Active NPI

Stephen T. Ruso, D.D.S., M.S., P.L.L.C.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Melbourne, FL
National Provider Identifier
1093243917
Registry record updated May 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
Legal business name
STEPHEN T. RUSO, D.D.S., M.S., P.L.L.C.
Practice address
3760 N Wickham Rd Ste 1
Melbourne, FL 32935-2326
Phone
(321) 242-9900
NPI assigned
May 23, 2017
Last updated
May 23, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2017

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

Authorized official

Name
Stephen Ruso, DDSNPI 1285913723
Title
Member
Phone
(813) 586-0560

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223X0400X Primary

Addresses

Primary practice location

3760 N Wickham Rd Ste 1
Melbourne, FL 32935-2326

Mailing address

3760 N Wickham Rd Ste 1
Melbourne, FL 32935-2326

National Provider Directory

National Provider Directory

Locations

3760 N Wickham Rd
Ste 1
Melbourne, FL 32935
Phone (321) 242-9900

Practitioners & affiliated clinicians

Practitioners 2

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": "1495497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1495497600000",
    "number": "1093243917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 N WICKHAM RD STE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 N WICKHAM RD STE 1",
            "city": "MELBOURNE",
            "state": "FL",
            "postal_code": "329352326",
            "telephone_number": "321-242-9900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STEPHEN T. RUSO, D.D.S., M.S., P.L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-23",
        "last_updated": "2017-05-23",
        "status": "A",
        "authorized_official_last_name": "RUSO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "813-586-0560",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melbourne, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2017; 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.