Individual provider Active NPI

Russell Norman Mosher III, DDS

  • General Practice Dentistry
  • Midlothian, VA
National Provider Identifier
1144058819
Registry record updated Jul 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401419125 Issued in VA
Practice address
14431 Sommerville CT Ste a
Midlothian, VA 23113-6812
Phone
(804) 794-4588
NPI assigned
Jul 24, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401419125 VA Primary

Addresses

Primary practice location

14431 Sommerville CT Ste a
Midlothian, VA 23113-6812

Mailing address

14431 Sommerville CT Ste a
Midlothian, VA 23113-6812
Phone (804) 794-4588

Other practice location 1

1320 Alverser Plz
Midlothian, VA 23113-2604
Phone (804) 379-6971

Other practice location 2

9015 Forest Hill Ave
North Chesterfield, VA 23235-3050
Phone (804) 596-4632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
0401419125VAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Russell Mosher, DDS, PC General Practice Past Accepting new patients
Russell N Mosher DDS PC Past Accepting new patients
M Scott Gore DDS PC General Practice PastSince Jul 28, 2024 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1721779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721779200000",
    "number": "1144058819",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14431 SOMMERVILLE CT STE A",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136812",
            "telephone_number": "804-794-4588"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14431 SOMMERVILLE CT STE A",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "231136812",
            "telephone_number": "804-794-4588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1320 Alverser Plz",
            "address_purpose": "LOCATION",
            "city": "Midlothian",
            "state": "VA",
            "postal_code": "231132604",
            "country_code": "US",
            "telephone_number": "804-379-6971",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9015 Forest Hill Ave",
            "address_purpose": "LOCATION",
            "city": "North Chesterfield",
            "state": "VA",
            "postal_code": "232353050",
            "country_code": "US",
            "telephone_number": "804-596-4632",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MOSHER",
        "first_name": "RUSSELL",
        "middle_name": "NORMAN",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-24",
        "last_updated": "2024-07-24",
        "certification_date": "2024-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401419125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midlothian, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2024; 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.