John E Russo, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN0013542 Issued in FL

Practice address

430 N Mills Ave
Orlando, FL 32803-5746

Phone

(407) 843-2112

Fax

(407) 843-1702

NPI assigned

Apr 18, 2006

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• John E. Russo, D.M.D, P.a.

  • General Practice Dentistry
  • Orlando, FL
  • NPI 1508680497
  NPD

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705190400000",
    "number": "1679538367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 N MILLS AVE STE 3",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035746",
            "telephone_number": "407-843-2112",
            "fax_number": "407-843-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "430 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328035746",
            "telephone_number": "407-843-2112",
            "fax_number": "407-843-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSO",
        "first_name": "JOHN",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-18",
        "last_updated": "2024-01-14",
        "certification_date": "2024-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN0013542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savannah Russell
• Tamara Lou Russell, ARNP
• Sandra Carolina Russi, M.A.
• Cristy L. Cox Russo, PH.D.
• Dynella Russo, FNP
• Joseph William Russo, DNP, CPNP
• Kari B Russo, LMHC, MS
• Richard G. Russo, DMD
• Delaney Rust
• Kelsey J Rust, CRNA

• General Practice Dentistry in Orlando, FL
• Providers in Orlando, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2024; 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.