Jessica Russo Revand, DMD, Ms, PLLC

Primary specialty

EndodonticsTaxonomy code 1223E0200X

Legal business name

JESSICA RUSSO REVAND, DMD, MS, PLLC

Doing business as

Russo Endodontics

Practice address

8987 Hersand Dr Ste 3
Burke, VA 22015-1604

Phone

(703) 503-0555

NPI assigned

Jan 7, 2021

Last updated

Jan 7, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jessica Russo Revand, DMD, MSNPI 1770712705

Title

Owner/Endodontist

Phone

(703) 503-0555

Specialties & licenses 1

Addresses

Other names 1

• Russo Endodontics Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Russo Revand, DMD, MS

  • Endodontics
  • Alexandria, VA
  • NPI 1770712705
  NPD Authorized official

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

{
    "created_epoch": "1609977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1669060364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10603 OLIVER ST",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220303913",
            "telephone_number": "202-270-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8987 HERSAND DR STE 3",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "220151604",
            "telephone_number": "703-503-0555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JESSICA RUSSO REVAND, DMD, MS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-07",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "RUSSO REVAND",
        "authorized_official_first_name": "JESSICA",
        "authorized_official_title_or_position": "OWNER/ENDODONTIST",
        "authorized_official_telephone_number": "703-503-0555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Russo Endodontics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jack a Merenda, Psy.D., Inc.
• Lina Jameel, DDS
• James L Gyuricza DDS PC
• Jeffrey I. Klioze, D.D.S., LTD
• Donna Faye Jennings, PA-C
• Kirti Johal, M.D.
• John-Mike Nelson, PLLC (Virginia Counseling Services)
• Angela Lynn John, OTR/L
• Elizabeth Johnson, PT, DPT
• Lina Ann Johnson, D.D.S.

• Endodontics in Burke, VA
• Providers in Burke, VA by specialty
• Endodontics in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.