Active NPI
Kristina D Russell, D.M.D.
- General Practice Dentistry
- Sarasota, FL
National Provider Identifier
1215117601
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DN18201
- Practice address
- 2171 Siesta Dr
Sarasota, FL 34239-5235 - Phone
- (941) 706-1505
- Fax
- (941) 554-8172
- NPI assigned
- Nov 14, 2007
- Sex
- Female
- 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 | DN18201 | FL | Primary |
Addresses
Primary practice location
2171 Siesta Dr
Sarasota, FL 34239-5235
Mailing address
2171 Siesta Dr
Sarasota, FL 34239-5235
Phone (941) 706-1505
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN18201 | FL | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1356912000000",
"number": "1215117601",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2171 SIESTA DR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342395235",
"telephone_number": "941-706-1505",
"fax_number": "941-554-8172"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2171 SIESTA DR",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342395235",
"telephone_number": "941-706-1505",
"fax_number": "941-554-8172"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUSSELL",
"first_name": "KRISTINA",
"middle_name": "D",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-11-14",
"last_updated": "2012-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "FL",
"license": "DN18201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.