NPIMap

Organization Active NPI

Jason E. Russell, DDS PA

  • Dentist
  • High Point, NC
National Provider Identifier
1689109340
Registry record updated May 1, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9115 Issued in NC
Legal business name
JASON E. RUSSELL, DDS PA
Practice address
510 Ferndale Blvd
Suite 102
High Point, NC 27262-4761
Phone
(336) 884-2212
Fax
(336) 884-4477
NPI assigned
May 1, 2017
Last updated
May 1, 2017By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 1, 2017

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

Authorized official

Name
Mrs. Kimberly R Russell
Title
Account Manager
Phone
(336) 884-2212

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9115 NC Primary

Addresses

Primary practice location

510 Ferndale Blvd
Suite 102
High Point, NC 27262-4761

Mailing address

510 Ferndale Blvd
Suite 102
High Point, NC 27262-4761
Phone (336) 884-2212

National Provider Directory

National Provider Directory

Locations

510 Ferndale Blvd
Ste 102
High Point, NC 27262
Phone (336) 884-2212

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1493596800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493596800000",
    "number": "1689109340",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "510 FERNDALE BLVD",
            "address_2": "SUITE 102",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624761",
            "telephone_number": "336-884-2212",
            "fax_number": "336-884-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "510 FERNDALE BLVD",
            "address_2": "SUITE 102",
            "city": "HIGH POINT",
            "state": "NC",
            "postal_code": "272624761",
            "telephone_number": "336-884-2212",
            "fax_number": "336-884-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JASON E. RUSSELL, DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-05-01",
        "last_updated": "2017-05-01",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "ACCOUNT MANAGER",
        "authorized_official_telephone_number": "336-884-2212",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "9115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in High Point, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2017; 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.