Jennifer Ann Russell, D.D.S., M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

12010066A Issued in IN

Practice address

1121 W Michigan St
Indianapolis, IN 46202-5211

Phone

(317) 274-7433

NPI assigned

Apr 2, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• GB Fishers

  dba Gorman & Bunch Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fishers, IN
  • NPI 1649772567
  NPD (past)
• Orthodontic Partners of Indiana, LLC

  dba Gorman & Bunch Orthodontics

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Noblesville, IN
  • NPI 1942089081
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1265552160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5115 N PENNSYLVANIA ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051038",
            "telephone_number": "317-726-0136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1121 W MICHIGAN ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462025211",
            "telephone_number": "317-274-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-02",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IN",
            "license": "12010066A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carl Ralph Russell III
• Danielle Nicole Russell
• Erin Russell
• Frances M Russell, MD
• Holly Russell, MS, OTR
• Jessica Russell
• Jordan Russell
• Katherine Russell
• Katherine Jane Russell, AU.D.
• Kaycee Sue Russell

• Orthodontics and Dentofacial Orthopedics Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.