Nicholas J. Russo, D.M.D

Primary specialty

DentistTaxonomy code 122300000X

License

G1-0001031 Issued in DE

Practice address

300 Foulk Rd Ste 101
Wilmington, DE 19803-3819

Phone

(302) 652-3775

Fax

(302) 652-8423

NPI assigned

Sep 16, 2010

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

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.

• Foulk Road Dental

  • General Practice Dentistry
  • Wilmington, DE
  • NPI 1750435350
  NPD (past)

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

{
    "created_epoch": "1284595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1284595200000",
    "number": "1407164197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 FOULK RD STE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033819",
            "telephone_number": "302-652-3775",
            "fax_number": "302-652-8423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOULK RD STE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033819",
            "telephone_number": "302-652-3775",
            "fax_number": "302-652-8423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "NICHOLAS",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-16",
        "last_updated": "2010-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "DE",
            "license": "G1-0001031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Nicole Russell, M.A., BCBA
• Rebecca Jean Russell, MD
• Frances Russo-Avena
• John N Russo, DDS
• Kimberly A. Russo, CRNA
• Sofia Danielle Russo, DO
• Gale Helen Rutan, MD
• Jane Choung Rutledge, D.M.D.
• Jeffrey Francis Rutledge, DMD
• Kennedy St. Clare Rutledge, PA-C

• Dentist in Wilmington, DE
• Providers in Wilmington, DE by specialty
• Dentist in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2010; 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.