Christopher John Russo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DN15234 Issued in FL

Practice address

1979 Longwood Lake Mary Rd
Suite 1013
Longwood, FL 32750-4670

Phone

(407) 320-0785

NPI assigned

Apr 22, 2008

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 5, 2015 through Oct 5, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1208822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1364342400000",
    "number": "1619141611",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 PONDVIEW LN",
            "city": "CELEBRATION",
            "state": "FL",
            "postal_code": "347474214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1979 LONGWOOD LAKE MARY RD",
            "address_2": "SUITE 1013",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504670",
            "telephone_number": "407-320-0785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "CHRISTOPHER",
        "middle_name": "JOHN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-22",
        "last_updated": "2013-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN15234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Ruiz
• Karen Marie Rumer, LMT
• Megan Elizabeth Runyan, MA, CCC-SLP
• Chasity Tierra Russell, LMHC
• Amy Faith Russo, P.A.
• Danielle Ryan, M.S.
• Robert Ryan, PT
• Kevin Sabina
• Susan Sablone
• Sacowi Medical Consultants Inc

• Dentist in Longwood, FL
• Providers in Longwood, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.