Joseph Russo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

057342 Issued in NY

Practice address

47 William St
Lyons, NY 14489-1544

Phone

(315) 946-6511

NPI assigned

May 5, 2013

Sex

Male

Sole proprietor

Yes

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

Enrolled in NY

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

Medicare enrollment (NPD)

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.

• Joseph J Russo DDS

  • Dental Clinic/Center
  • Lyons, NY
  • NPI 1942781984
  NPD (past) Authorized official

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

{
    "created_epoch": "1367712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1609211663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "47 WILLIAM ST",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144891544",
            "telephone_number": "315-946-6511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 WILLIAM ST",
            "city": "LYONS",
            "state": "NY",
            "postal_code": "144891544",
            "telephone_number": "315-946-6511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOSEPH",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-05-05",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "057342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rite Aid of New York Inc (Rite Aid Pharmacy 02756)
• Michelle Rivers
• Kimberly Ann Robinson
• Dawn M Rose, RN
• Judith A Ross
• Marybeth M Schram, ATC
• Sheila Schuh, LCAT
• Michael Patrick Shea, LMSW
• Susan M Sheets, R.N.
• Amy Shoff, LMSW

• Dentist in Lyons, NY
• Providers in Lyons, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.