Active NPI
Russell R Hilliard, D.D.S.
- General Practice Dentistry
- Houston, TX
National Provider Identifier
1659364198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 12735
- Practice address
- 4910 Willowbend Blvd
Suite C
Houston, TX 77035-3222 - Phone
- (713) 729-1813
- Fax
- (713) 729-6080
- NPI assigned
- Aug 30, 2005
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 12735 | TX | Primary |
Addresses
Primary practice location
4910 Willowbend Blvd
Suite C
Houston, TX 77035-3222
Mailing address
4910 Willowbend Blvd
Suite C
Houston, TX 77035-3222
Phone (713) 729-1813
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12735 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Dental Group, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1125360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659364198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4910 WILLOWBEND BLVD",
"address_2": "SUITE C",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770353222",
"telephone_number": "713-729-1813",
"fax_number": "713-729-6080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4910 WILLOWBEND BLVD",
"address_2": "SUITE C",
"city": "HOUSTON",
"state": "TX",
"postal_code": "770353222",
"telephone_number": "713-729-1813",
"fax_number": "713-729-6080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLIARD",
"first_name": "RUSSELL",
"middle_name": "R",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-08-30",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "TX",
"license": "12735",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Houston, TX
Sources for this page
- 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.