Russell James Czerw, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

17470 Issued in TX

Practice address

2410 Stanley Rd
Dentac Suite 200J
Fort Sam Houston, TX 78234-7529

Phone

(210) 295-2743

Fax

(210) 295-2602

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1629003835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 STANLEY RD",
            "address_2": "DENTAC SUITE 200J",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347529",
            "telephone_number": "210-295-2743",
            "fax_number": "210-295-2602"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 STANLEY RD",
            "address_2": "DENTAC SUITE 200J",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782347529",
            "telephone_number": "210-295-2743",
            "fax_number": "210-295-2602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CZERW",
        "first_name": "RUSSELL",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "0410271",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "17470",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008137",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kyle Cunningham, PT, DPT
• Martin Paul Curry, O.D., D.O.
• Robin E Cushing, PA-C
• Cyril Carreon Custodio
• Danica Cutshall, MD
• Robert D'Angelo, PA-C
• Lisa Sarkees Dacko
• Nemat Matthew Dadfar, D.O.
• Udaya Dahal, PA
• John William Daigle, M.D.

• General Practice Dentistry in Fort Sam Houston, TX
• Providers in Fort Sam Houston, TX by specialty
• General Practice Dentistry in Texas

• 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.