Thomas D. Russo, D.M.D., P.C.

Primary specialty

DentistTaxonomy code 122300000X

License

15641 Issued in MA

Legal business name

THOMAS D. RUSSO, D.M.D., P.C.

Practice address

63 Shore Rd Ste 13
Winchester, MA 01890-2828

Phone

(781) 721-4700

Fax

(781) 729-0798

NPI assigned

Feb 9, 2009

Organization subpart

No

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

Authorized official

Name

Thomas D Russo, D.M.D.NPI 1285836452

Title

President

Phone

(781) 721-4700

Specialties & licenses 1

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas David Russo, D.M.D.

  • Dentist
  • Winchester, MA
  • NPI 1285836452
  NPD (past) Authorized official

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529539200000",
    "number": "1154560589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "63 SHORE RD STE 13",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902828",
            "telephone_number": "781-721-4700",
            "fax_number": "781-729-0798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "63 SHORE RD STE 13",
            "city": "WINCHESTER",
            "state": "MA",
            "postal_code": "018902828",
            "telephone_number": "781-721-4700",
            "fax_number": "781-729-0798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS D. RUSSO, D.M.D., P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2018-06-21",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "781-721-4700",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MA",
            "license": "15641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0263001",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "661706",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS / BLUE SHIELD",
            "identifier": "RU10679",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert J Terzian, D.M.D.
• Sapna Malla Thakuri
• Andrea Cerulo Thayer, D.C.
• Craig Charles Thayer, D.C.
• Linda M Thebeau, LCMT
• Cherry T. Thomas
• Lia Thomas, PA-C
• Sockviechhea Thou, NP
• Lauren Tierney
• Christina Lynne Toland, PSY.D.

• Dentist in Winchester, MA
• Providers in Winchester, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2018; 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.