Charles D Russo, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN008338 Issued in FL

Practice address

2801 N University Dr
Suite 102
Coral Springs, FL 33065-5057

Phone

(954) 752-1045

Fax

(954) 344-9651

NPI assigned

Dec 4, 2006

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295803443",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 N UNIVERSITY DR",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655057",
            "telephone_number": "954-752-1045",
            "fax_number": "954-344-9651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 N UNIVERSITY DR",
            "address_2": "SUITE 102",
            "city": "CORAL SPRINGS",
            "state": "FL",
            "postal_code": "330655057",
            "telephone_number": "954-752-1045",
            "fax_number": "954-344-9651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CHARLES",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN008338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karina Murillo Ruiz, PA-C
• Luz Adriana Ruiz
• Debralee Anne Ruocco, P.A.-C
• Nathaly Johanna Rusinque, OTA
• Michael Loyd Russ, MD
• Diana Elizabeth Russo
• Sara Russo, MD
• Linda Ruza, MSW, CAP, MAC, CCTP
• Joshua Marc Rycus, D.O.,P.A.
• S4F Health Solutions

• Oral and Maxillofacial Surgery (Dentist) in Coral Springs, FL
• Providers in Coral Springs, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.