Individual provider Active NPI

Michela Russo, DDS

  • General Practice Dentistry
  • Parsippany, NJ
National Provider Identifier
1386856391
Registry record updated Aug 15, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DI19775 Issued in NJ
Practice address
362 Parsippany Road
Suite A4
Parsippany, NJ 07054
Phone
(973) 428-1515
Fax
(973) 428-7389
NPI assigned
May 3, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DI19775 NJ Primary

Addresses

Primary practice location

362 Parsippany Road
Suite A4
Parsippany, NJ 07054

Mailing address

362 Parsippany Road
Suite A4
Parsippany, NJ 07054
Phone (973) 428-1515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DI19775NJMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187136000000",
    "number": "1386856391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "362 PARSIPPANY ROAD",
            "address_2": "SUITE A4",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "07054",
            "telephone_number": "973-428-1515",
            "fax_number": "973-428-7389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "362 PARSIPPANY ROAD",
            "address_2": "SUITE A4",
            "city": "PARSIPPANY",
            "state": "NJ",
            "postal_code": "07054",
            "telephone_number": "973-428-1515",
            "fax_number": "973-428-7389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "MICHELA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2007-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI19775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Parsippany, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.