Russel Mulamba DDS LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12010225 Issued in IN

Legal business name

RUSSEL MULAMBA DDS LLC

Doing business as

pike plaza dental

Practice address

5122 W Pike Plaza Rd
Indianapolis, IN 46254-3003

Phone

(317) 293-1595

NPI assigned

May 9, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Russel Mulamba, D.D.S.NPI 1831244474

Title

President

Phone

(317) 293-1595

Specialties & licenses 1

Addresses

Other names 1

• pike plaza dental Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russel Mulamba, D.D.S

  • General Practice Dentistry
  • Denison, TX
  • NPI 1831244474
  NPD (past) Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1336353598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5122 W PIKE PLAZA RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462543003",
            "telephone_number": "317-293-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5122 W PIKE PLAZA RD",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462543003",
            "telephone_number": "317-293-1595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RUSSEL MULAMBA DDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-09",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULAMBA",
        "authorized_official_first_name": "RUSSEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-293-1595",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12010225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "pike plaza dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kevin Rusnak
• Mary C Rusnak, RN
• Rachel Ann Rusnak, M.A.ED CCC-SLP
• Jason D Russ, MD
• Jessica Ann Russ, AU.D., CCC-A
• Mica Russell-Hays, LCSW
• Alison Hundt Russell, M.ED., LMHC
• Arielle Faye Russell, MD
• Audrey M Russell, BCBA
• Ayana D Russell, NP-C

• General Practice Dentistry in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.