Robert Ross Russell, D.M.D., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN012716 Issued in GA

Practice address

2402 Loganville Hwy
Suite 500
Grayson, GA 30017-1689

Phone

(770) 236-9660

Fax

(770) 236-9664

NPI assigned

Sep 26, 2007

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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 and National Provider Directory roles.

• Docaligners, LLC

  • Dental Clinic/Center
  • Watkinsville, GA
  • NPI 1033969324
  NPD

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

{
    "created_epoch": "1190764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1190764800000",
    "number": "1356538151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 LOGANVILLE HWY",
            "address_2": "SUITE 500",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171689",
            "telephone_number": "770-236-9660",
            "fax_number": "770-236-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2402 LOGANVILLE HWY",
            "address_2": "SUITE 500",
            "city": "GRAYSON",
            "state": "GA",
            "postal_code": "300171689",
            "telephone_number": "770-236-9660",
            "fax_number": "770-236-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "ROSS",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-26",
        "last_updated": "2007-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "DN012716",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlene Richardson
• Carla Rios-Hernandez
• Lucette Rivera, M.ED.,CCC-SLP
• Courage Roberts
• Corliss A Rupp, M.D.
• Matthew Ryan
• Meda Saiu, RPH
• Katherine E. Sanford, RD, LDN
• Deshia R. Saucer
• Kathryn Sawyer, CPNP

• All providers in Grayson, GA
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 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.

Verify at the official NPI Registry.