Frank Russomanno Jr., D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11333 Issued in MN

Practice address

8910 Penn Ave S
Bloomington, MN 55431-2025

Phone

(952) 881-0504

Fax

(952) 884-0188

NPI assigned

Nov 1, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Frank Russomanno, Jr, DDS, P.a.

  dba Amber Leaf Family Dental

  • Dentist
  • Bloomington, MN
  • NPI 1598129942
  Authorized official Same address or phone

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548347586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1423 KINGSWOOD PONDS RD",
            "city": "EAGAN",
            "state": "MN",
            "postal_code": "551222878",
            "telephone_number": "952-484-8703",
            "fax_number": "952-884-0188"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8910 PENN AVE S",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554312025",
            "telephone_number": "952-881-0504",
            "fax_number": "952-884-0188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSOMANNO",
        "first_name": "FRANK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Briana Rud
• Kathleen Ann Linnan Rudgers, PTA
• Eleanor Running
• Julia Rupp
• Kelsea Jaye Rush, CNM
• Allison Hailey Ruthe, PT, DPT
• Constance Marie Rutledge, CRNA
• Nicole Linn Rutt
• Faith Gakii Rwitoh
• Conor S Ryan, MD

• General Practice Dentistry in Bloomington, MN
• Providers in Bloomington, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.