Jenny S. Russell
Individual provider Active NPI Dental Assistant · Ellington, MO
NPI 1356437024 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1356437024
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dental Assistant 126800000X
- Practice address
- 115 Walnut St.
Ellington, MO 63638 - Phone
- (573) 663-3177
- Fax
- (573) 663-3188
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Assistant | 126800000X | Yes |
Addresses
Primary practice location
115 Walnut St.
Ellington, MO 63638
Mailing address
PO Box 579
Ellington, MO 63638-0579
Phone (573) 663-7529
Other providers in Ellington, MO
- Shawna Renee Myers
- Shelby Nicole Ohrenberg
- Paul De Vries Rains
- Iris Fae Ross
- Rodney T. Rubi
- Rebecca Rae Singleton
- Southeast Health Center of Reynolds County LLC
- Southeast Health Center of Reynolds County, LLC
- Southeast Health Center of Reynolds County, LLC
- Southeast Health Center of Reynolds LLC
All providers in Ellington, MO · Dental Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.