Henry Ralph Russo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

042549 Issued in NY

Practice address

3010 Westchester Ave
Suite 202
Purchase, NY 10577-2535

Phone

(914) 251-0117

Fax

(914) 251-0254

NPI assigned

Aug 1, 2013

Sex

Male

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 NY

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

State licenses

Practice roles

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

• Rye Brook Dental Associates, P.C.

  • General Practice Dentistry
  • Purchase, NY
  • NPI 1467583716
  NPD (past) Authorized official

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

{
    "created_epoch": "1375315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1375315200000",
    "number": "1316379217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3010 WESTCHESTER AVE",
            "address_2": "SUITE 202",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772535",
            "telephone_number": "914-251-0117",
            "fax_number": "914-251-0254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3010 WESTCHESTER AVE",
            "address_2": "SUITE 202",
            "city": "PURCHASE",
            "state": "NY",
            "postal_code": "105772535",
            "telephone_number": "914-251-0117",
            "fax_number": "914-251-0254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "HENRY",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-08-01",
        "last_updated": "2013-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "042549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Donna Marie Romandetto, MS, OTR/L
• Christina Marie Rosado, PT
• Jeffrey S Rosenfield, M.D.
• Gregory Adam Rosner, M.D.
• Christine Russo-Mayer, AU.D.
• Lindsay Nicole Rutherford, DMD, MD
• Rye Brook Dental Associates, P.C.
• Karen Safris, LMSW
• Nicole Sanchez
• Ruth Milena Sanchez, MD

• Dentist in Purchase, NY
• Providers in Purchase, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 1, 2013; 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.