Toni Lynn Russo, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

10105 Issued in CT

Practice address

233 Hazard Ave
Enfield, CT 06082-4647

Phone

(860) 749-6622

NPI assigned

May 9, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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.

• Enfield Pediatric Dentistry LLC

  • Pediatric Dentistry
  • Enfield, CT
  • NPI 1790068500
  NPD (past) Authorized official

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

{
    "created_epoch": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1493856000000",
    "number": "1457565707",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "233 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824647",
            "telephone_number": "860-749-6622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "233 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824647",
            "telephone_number": "860-749-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "TONI",
        "middle_name": "LYNN",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-09",
        "last_updated": "2017-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CT",
            "license": "10105",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MA",
            "license": "DN1855254",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Izabela Roszkowska
• Amy Beth Rothenberg, ND NATUROPATHIC DOCT
• Kelly Alice Rowan, LPC
• Justin Lee Rush, ATC
• Paige Russo
• Katherine Snow Rutt, APRN
• Tracey Ruvolo, P.T
• Danielle Sabelli, OD
• Jennifer Marie Sacco, DOCTOR OF PHARMACY,
• Kevin E Sadowski, MSN, FNP-C

• Pediatric Dentistry in Enfield, CT
• Providers in Enfield, CT by specialty
• Pediatric Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2017; 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.