Active NPI
Russ P Read, DDS
- Endodontics
- Missoula, MT
National Provider Identifier
1306965116
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 1530
- Practice address
- 705 S Reserve St
Missoula, MT 59801-2131 - Phone
- (406) 542-1600
- Fax
- (406) 542-8945
- NPI assigned
- Mar 29, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 1530 | MT | Primary |
Addresses
Primary practice location
705 S Reserve St
Missoula, MT 59801-2131
Mailing address
705 S Reserve St
Missoula, MT 59801-2131
Phone (406) 542-1600
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 131365 | Medicaid | MT |
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 |
|---|---|---|---|
| 1530 | MT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Missoula Endodontics | Endodontics | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Missoula, MT
- NPI 1831034701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175126400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1306965116",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "705 S RESERVE ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598012131",
"telephone_number": "406-542-1600",
"fax_number": "406-542-8945"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "705 S RESERVE ST",
"city": "MISSOULA",
"state": "MT",
"postal_code": "598012131",
"telephone_number": "406-542-1600",
"fax_number": "406-542-8945"
}
],
"practiceLocations": [],
"basic": {
"last_name": "READ",
"first_name": "RUSS",
"middle_name": "P",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "MT",
"license": "1530",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "131365",
"state": "MT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Missoula, MT
Sources for this page
- 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.