Cortni Marie Russell, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30022782 Issued in OH

Practice address

854 E Aurora Rd
Macedonia, OH 44056-1904

Phone

(330) 908-0101

NPI assigned

Aug 26, 2008

Last updated

Dec 1, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1730336363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2834 BROOKS CT",
            "city": "BROADVIEW HEIGHTS",
            "state": "OH",
            "postal_code": "441473671",
            "telephone_number": "440-289-4790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "854 E AURORA RD",
            "city": "MACEDONIA",
            "state": "OH",
            "postal_code": "440561904",
            "telephone_number": "330-908-0101"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1480 Grandview Ave",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "OH",
            "postal_code": "432122862",
            "country_code": "US",
            "telephone_number": "614-488-3313",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CORTNI",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30022782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robertta Ann Rhoda, LDO
• Robin C Rice, DOULA
• Robert J Donna (None)
• Shanices Robinson, LSW
• Jacob Rosebrock
• Dtodd Russell, DDS
• Taufika H Sakhawat, LISW
• Patricia Lynne Scott
• Selina Dickenson
• Tammy Seljan

• Dentist in Macedonia, OH
• Providers in Macedonia, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.