Individual provider Active NPI

Linda Kulma Russow, D.D.S.

  • General Practice Dentistry
  • Apopka, FL
National Provider Identifier
1144314279
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN8332 Issued in FL
Practice address
2216 E Semoran Blvd
Apopka, FL 32703-5733
Phone
(407) 529-4973
Fax
(407) 889-2037
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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 DN8332 FL Primary

Addresses

Primary practice location

2216 E Semoran Blvd
Apopka, FL 32703-5733

Mailing address

856 Wetstone PL
Sanford, FL 32771-7144
Phone (407) 529-4973

Other identifiers 1

IdentifierTypeStateIssuer
077015900MedicaidFL

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
DN8332FLMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1144314279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "856 WETSTONE PL",
            "city": "SANFORD",
            "state": "FL",
            "postal_code": "327717144",
            "telephone_number": "407-529-4973",
            "fax_number": "407-889-2035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2216 E SEMORAN BLVD",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327035733",
            "telephone_number": "407-529-4973",
            "fax_number": "407-889-2037"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOW",
        "first_name": "LINDA",
        "middle_name": "KULMA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN8332",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "077015900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Apopka, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.