Russell J. Tibbetts, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

894 Issued in DE

Practice address

3516 Silverside Rd
#17 The Commons
Wilmington, DE 19810-4932

Phone

(302) 479-5959

Fax

(302) 479-5956

NPI assigned

Feb 21, 2012

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 DE

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 and National Provider Directory roles.

• Russell J Tibbetts DDS PA

  • Dentist
  • Wilmington, DE
  • NPI 1487662375
  NPD (past) Authorized official

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

{
    "created_epoch": "1329782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329782400000",
    "number": "1366715419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3516 SILVERSIDE RD",
            "address_2": "#17 THE COMMONS",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104932",
            "telephone_number": "302-479-5959",
            "fax_number": "302-479-5956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3516 SILVERSIDE RD",
            "address_2": "#17 THE COMMONS",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198104932",
            "telephone_number": "302-479-5959",
            "fax_number": "302-479-5956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIBBETTS",
        "first_name": "RUSSELL",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-02-21",
        "last_updated": "2012-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrive Supportive Services
• Chandler Thrower
• Vruti Thumar
• Ruth W Thuo, MSN
• Emma Nicole Thwaites
• Scott Tibbetts, DMD
• Frederick Tibuah
• Tice Pediatric Physical Therapy LLC
• Lauren M. Tice, RD
• Lindsay C. Tice, PT

• General Practice Dentistry in Wilmington, DE
• Providers in Wilmington, DE by specialty
• General Practice Dentistry in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; 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.