Yellow Springs Dental Care John T Russell DDS Inc.

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

30.013562 Issued in OH

Legal business name

YELLOW SPRINGS DENTAL CARE JOHN T RUSSELL DDS INC.

Practice address

1030 Xenia Ave
Yellow Springs, OH 45387-1632

Phone

(937) 767-7731

NPI assigned

May 3, 2007

Organization subpart

No

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

Authorized official

Name

Dr. John T Russell, DDS

Title

Clinician

Phone

(937) 767-7731

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Yellow Springs Dental Care Former legal business name

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

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1274227200000",
    "number": "1568684140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 XENIA AVE",
            "address_2": "PO BOX 839",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871632",
            "telephone_number": "937-767-7731"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 XENIA AVE",
            "city": "YELLOW SPRINGS",
            "state": "OH",
            "postal_code": "453871632",
            "telephone_number": "937-767-7731"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "YELLOW SPRINGS DENTAL CARE JOHN T RUSSELL DDS INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-03",
        "last_updated": "2010-05-19",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CLINICIAN",
        "authorized_official_telephone_number": "937-767-7731",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "OH",
            "license": "30.013562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "DN16600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1679511489",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "30.013562",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Yellow Springs Dental Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Christopher Seinjen Wharton, PA-C
• Debra Williamson
• Michael C Wilson, MSW
• Yellow Springs Chiropractic, LLC
• Yellow Springs Chiropratic II, LLC (Yellow Springs Chiropractic)
• Yellow Springs Pharmacy LLC (Yellow Springs Pharmacy)
• Yellow Springs Primary Care, Inc
• Yellow Springs Primary Care, Inc
• Yellow Springs Primary Care, Inc
• Mary K Yelton

• Dental Clinic/Center in Yellow Springs, OH
• Providers in Yellow Springs, OH by specialty
• Dental Clinic/Center in Ohio

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