Individual provider Active NPI

Sharon S. Russell, D.D.S.

  • General Practice Dentistry
  • Denver, CO
National Provider Identifier
1487610812
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
105995 Issued in CO
Practice address
3300 E 1St Ave
Suite 580
Denver, CO 80206-5810
Phone
(303) 320-1640
Fax
(303) 333-9148
NPI assigned
Apr 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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 105995 CO Primary

Addresses

Primary practice location

3300 E 1St Ave
Suite 580
Denver, CO 80206-5810

Mailing address

3300 E 1St Ave
Suite 580
Denver, CO 80206-5810
Phone (303) 320-1640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160609002467 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466742036

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1145923200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1235001600000",
    "number": "1487610812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3300 E 1ST AVE",
            "address_2": "SUITE 580",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802065810",
            "telephone_number": "303-320-1640",
            "fax_number": "303-333-9148"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E 1ST AVE",
            "address_2": "SUITE 580",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802065810",
            "telephone_number": "303-320-1640",
            "fax_number": "303-333-9148"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "SHARON",
        "middle_name": "S.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-25",
        "last_updated": "2009-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105995",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Denver, CO

Sources for this page

Verify at the official NPI Registry.