Justin Russo DDS PA

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

Legal business name

JUSTIN RUSSO DDS PA

Practice address

3811 Ed Dr Ste 120
Raleigh, NC 27612

Phone

(919) 890-5147

NPI assigned

Jun 1, 2018

Organization subpart

No

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

Authorized official

Name

Dr. Justin Russo, DDSNPI 1205149275

Title

Owner

Phone

(919) 890-5147

Specialties & licenses 1

Addresses

Other names 1

• Russo Dentistry 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.

• Justin Russo, D.D.S.

  • General Practice Dentistry
  • Raleigh, NC
  • NPI 1205149275
  NPD (past) Authorized official

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1553040000000",
    "number": "1346732674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3811 ED DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276122393",
            "telephone_number": "919-890-5147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3811 ED DR STE 120",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27612",
            "telephone_number": "919-890-5147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUSTIN RUSSO DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-01",
        "last_updated": "2019-03-20",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-890-5147",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russo Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Garrett Justice
• Kirsten Bernadette Justice, LPCA
• Rachel Justice
• Stephanie C Justice, LPC
• Justin M Russo DDS PLLC
• Gianna Justo
• Justus Transportation LLC
• K. Jasinski, D.M.D., P.C.
• K. Jasinski, D.M.D., P.C.
• K. Jasinski, D.M.D., P.C.

• Dental Clinic/Center in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Dental Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2019; 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.