NPIMap

Organization Active NPI

Sharon Russell DDS PC

Doing business as The Maryland Oral Surgery Group

  • General Practice Dentistry
  • Upper Marlboro, MD
National Provider Identifier
1386073054
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
14351 Issued in MD
Legal business name
SHARON RUSSELL DDS PC
Doing business as
The Maryland Oral Surgery Group
Practice address
9632 Marlboro Pike
Melwood Professional Center
Upper Marlboro, MD 20772-3670
Phone
(240) 320-7331
NPI assigned
Nov 4, 2013
Organization subpart
Yes
Parent organization
MARYLAND DENTAL SPECIALISTAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

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

Authorized official

Name
Mark Russell
Title
Coo
Phone
(240) 320-7331

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X 14351 MD
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 14351 MD Primary
ProsthodonticsGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0700X

Addresses

Primary practice location

9632 Marlboro Pike
Melwood Professional Center
Upper Marlboro, MD 20772-3670

Mailing address

9632 Marlboro Pike
Melwood Professional Center
Upper Marlboro, MD 20772-3670
Phone (240) 320-7331

Other identifiers 1

IdentifierTypeStateIssuer
14351MedicaidMD

Other names 1

  • The Maryland Oral Surgery Group Doing business as

National Provider Directory

National Provider Directory
Part of
Sharon Russell DDS PC

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1383523200000",
    "number": "1386073054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9632 MARLBORO PIKE",
            "address_2": "MELWOOD PROFESSIONAL CENTER",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "240-320-7331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9632 MARLBORO PIKE",
            "address_2": "MELWOOD PROFESSIONAL CENTER",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207723670",
            "telephone_number": "240-320-7331"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHARON RUSSELL DDS PC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MARYLAND DENTAL SPECIALIST",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "240-320-7331"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MD",
            "license": "14351",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "14351",
            "primary": true
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Prosthodontics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14351",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Maryland Oral Surgery Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Upper Marlboro, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; 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.