Active NPI
Russell Trapnell, DMD
- Orthodontics and Dentofacial Orthopedics Dentistry
- Albuquerque, NM
National Provider Identifier
1609098789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- DD3190
- Practice address
- 2010 Wyoming Blvd NE Ste G
Albuquerque, NM 87112-2679 - Phone
- (505) 296-0761
- Fax
- (505) 296-7543
- NPI assigned
- May 2, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | DD3190 | NM | Primary |
| General Practice Dentistry | 1223G0001X | 9183 | CO |
Addresses
Primary practice location
2010 Wyoming Blvd NE Ste G
Albuquerque, NM 87112-2679
Mailing address
2010 Wyoming Blvd NE Ste G
Albuquerque, NM 87112-2679
Phone (505) 296-0761
Other practice location 1
6401 Los Volcanes Rd NW
Albuquerque, NM 87121
Phone (505) 835-5650
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 09328874 | Medicaid | CO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9183 | CO | MD | General Practice Dentistry |
| DD3190 | NM | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669680000000",
"number": "1609098789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2010 WYOMING BLVD NE STE G",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122679",
"telephone_number": "505-296-0761",
"fax_number": "505-296-7543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2010 WYOMING BLVD NE STE G",
"city": "ALBUQUERQUE",
"state": "NM",
"postal_code": "871122679",
"telephone_number": "505-296-0761",
"fax_number": "505-296-7543"
}
],
"practiceLocations": [
{
"address_1": "6401 Los Volcanes Rd NW",
"address_purpose": "LOCATION",
"city": "Albuquerque",
"state": "NM",
"postal_code": "87121",
"country_code": "US",
"telephone_number": "505-835-5650",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TRAPNELL",
"first_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-02",
"last_updated": "2022-11-29",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "NM",
"license": "DD3190",
"primary": true
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "9183",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "09328874",
"state": "CO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Albuquerque, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.