Gregory Scott Russell, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

13423 Issued in MD

Practice address

11200 Racetrack Rd Ste 204
Berlin, MD 21811-3808

Phone

(410) 208-3333

Fax

(410) 208-3330

NPI assigned

Jan 23, 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MD

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

Practice roles

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.

• Gregory S Russell, DMD, P.a.

  • Endodontics
  • Berlin, MD
  • NPI 1619267903
  NPD (past) Authorized official

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

{
    "created_epoch": "1137974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419292800000",
    "number": "1760452890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11200 RACETRACK RD STE 204",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113808",
            "telephone_number": "410-208-3333",
            "fax_number": "410-208-3330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 RACETRACK RD STE 204",
            "city": "BERLIN",
            "state": "MD",
            "postal_code": "218113808",
            "telephone_number": "410-208-3333",
            "fax_number": "410-208-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "GREGORY",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-23",
        "last_updated": "2014-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "MD",
            "license": "13423",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MARYAND LICENSE NUMBER",
            "identifier": "13423",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Diana Roze, LAC
• Cameron Runyon, LCSW-C
• Christopher S Rush, D.C.
• Tracy Lyn Rush, D.C.
• Joseph Michael Rushton, LCSW-C
• Marissa Ruth, RBT
• Jasmine Saby
• Salem Gunn Enterprises
• Salty Solutions
• Yessica Santos

• Endodontics in Berlin, MD
• Providers in Berlin, MD by specialty
• Endodontics in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2014; 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.