Individual provider Active NPI

Russell C. Parker, D.M.D.

  • General Practice Dentistry
  • Decatur, AL
National Provider Identifier
1407061252
Registry record updated Aug 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D.007168-C Issued in AL
Practice address
2012 Danville Park Dr SW
Decatur, AL 35603-1832
Phone
(256) 973-8093
NPI assigned
May 14, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2023

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 D.007168-C AL Primary

Addresses

Primary practice location

2012 Danville Park Dr SW
Decatur, AL 35603-1832

Mailing address

2012 Danville Park Dr SW
Decatur, AL 35603-1832
Phone (256) 973-8093

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
D.007168-CALMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Russell C Parker DMD PLLC CurrentSince Oct 29, 2023 Accepting new patients
J.a. Willis, DMD and Russell Parker, DMD Family Dentistry General Practice Past Accepting new patients
Gulf Islands Dentistry, PLLC Past Accepting new patients

Locations

2012 Danville Park Dr SW
Decatur, AL 35603
Phone (256) 350-5006

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1691971200000",
    "number": "1407061252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2012 DANVILLE PARK DR SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031832",
            "telephone_number": "256-973-8093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2012 DANVILLE PARK DR SW",
            "city": "DECATUR",
            "state": "AL",
            "postal_code": "356031832",
            "telephone_number": "256-973-8093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PARKER",
        "first_name": "RUSSELL",
        "middle_name": "C.",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2023-08-14",
        "certification_date": "2023-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "D.007168-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2023; 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.