NPIMap

Organization Active NPI

Foulk Road Dental

Doing business as park place dental

  • General Practice Dentistry
  • Wilmington, DE
National Provider Identifier
1750435350
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
GI0000719 Issued in DE
Legal business name
FOULK ROAD DENTAL
Doing business as
park place dental
Practice address
300 Foulk Rd
Suite 101
Wilmington, DE 19803-3886
Phone
(302) 652-3775
NPI assigned
Jan 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. John N Russo, D.D.S.NPI 1871729897
Title
Owner
Phone
(302) 652-3775

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X GI0000719 DE Primary
General Practice Dentistry 1223G0001X GI0001031 DE
General Practice Dentistry 1223G0001X GI00001157 DE
General Practice Dentistry 1223G0001X GI00001156 DE

Addresses

Primary practice location

300 Foulk Rd
Suite 101
Wilmington, DE 19803-3886

Mailing address

1100 Lovering Ave
Wilmington, DE 19806-3273
Phone (302) 652-7447

Other names 1

  • park place dental Doing business as

National Provider Directory

National Provider Directory

Locations

300 Foulk Rd
Ste 101
Wilmington, DE 19803
Phone (302) 652-3775

Practitioners & affiliated clinicians

Practitioners 4

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": "1169424000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1750435350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 LOVERING AVE",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198063273",
            "telephone_number": "302-652-7447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 FOULK RD",
            "address_2": "SUITE 101",
            "city": "WILMINGTON",
            "state": "DE",
            "postal_code": "198033886",
            "telephone_number": "302-652-3775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOULK ROAD DENTAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-652-3775",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "GI0000719",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "GI0001031",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "GI00001157",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DE",
            "license": "GI00001156",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "park place dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Wilmington, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.