Active NPI
Russell Rima, RUSSELL RIMA D.D.S.
- General Practice Dentistry
- Bullhead City, AZ
National Provider Identifier
1174780415
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128b(14) exclusion effective Feb 4, 2009.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D3339
- Practice address
- 1980 Hiway 95
Bullhead City, AZ 86442-6752 - Phone
- (928) 758-2778
- Fax
- (928) 758-7595
- NPI assigned
- May 22, 2008
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D3339 | AZ | Primary |
Addresses
Primary practice location
1980 Hiway 95
Bullhead City, AZ 86442-6752
Mailing address
1980 Hiway 95
Bullhead City, AZ 86442-6752
Phone (928) 758-2778
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D3339 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211414400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211414400000",
"number": "1174780415",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1980 HIWAY 95",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864426752",
"telephone_number": "928-758-2778",
"fax_number": "928-758-7595"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1980 HIWAY 95",
"city": "BULLHEAD CITY",
"state": "AZ",
"postal_code": "864426752",
"telephone_number": "928-758-2778",
"fax_number": "928-758-7595"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RIMA",
"first_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "RUSSELL RIMA D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-05-22",
"last_updated": "2008-05-22",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D3339",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bullhead City, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.