Red Hills Oral and Facial Surgery, PA

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

RED HILLS ORAL AND FACIAL SURGERY, PA

Doing business as

Red Hills Oral and Facial Surgery

Practice address

2648 Centennial PL
Tallahassee, FL 32308-0572

Phone

(850) 523-3000

Fax

(850) 523-0831

NPI assigned

Aug 19, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Russell Walther, DDS, MDNPI 1073837746

Title

Owner

Phone

(352) 284-0232

Specialties & licenses 1

Addresses

Other names 1

• Red Hills Oral and Facial Surgery Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Russell Walther, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Tallahassee, FL
  • NPI 1073837746
  NPD Authorized official

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

{
    "created_epoch": "1597795200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597795200000",
    "number": "1427660703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2648 CENTENNIAL PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080572",
            "telephone_number": "850-523-3000",
            "fax_number": "850-523-0831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2648 CENTENNIAL PL",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323080572",
            "telephone_number": "850-523-3000",
            "fax_number": "850-523-0831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RED HILLS ORAL AND FACIAL SURGERY, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-19",
        "last_updated": "2020-08-19",
        "certification_date": "2020-08-19",
        "status": "A",
        "authorized_official_last_name": "WALTHER",
        "authorized_official_first_name": "RUSSELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "352-284-0232",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MD"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Red Hills Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kiana Reaves
• Shobha Rebala, APRN
• Recover. Restart. Refreshed, Inc.
• Red Hills Counseling Center, Inc.
• Red Hills Dental Associates
• Red Hills Surgical Center, LLC
• Red Hills Transit LLC
• Denise Karen Redd, ARNP
• Stella Redd
• Destiny Shell Reddick

• Oral and Maxillofacial Surgery (Dentist) in Tallahassee, FL
• Providers in Tallahassee, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2020; 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.