Thomas Duckworth Russell III, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2338 Issued in TN

Practice address

130 Peachtree PLZ
Brownsville, TN 38012-2500

Phone

(731) 772-2107

Fax

(731) 772-1710

NPI assigned

Oct 23, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Russell Dental Group, P.C.

  • General Practice Dentistry
  • Brownsville, TN
  • NPI 1942297643
  NPD (past)

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760565642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 PEACHTREE PLZ",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380122500",
            "telephone_number": "731-772-2107",
            "fax_number": "731-772-1710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 PEACHTREE PLZ",
            "city": "BROWNSVILLE",
            "state": "TN",
            "postal_code": "380122500",
            "telephone_number": "731-772-2107",
            "fax_number": "731-772-1710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "THOMAS",
        "middle_name": "DUCKWORTH",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "2338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Phillips Roberts, PHARMD
• Robert N Rooks, DDS
• Russell Dental Group, P.C.
• Andrew David Russell, D.D.S.
• Thomas Duckworth Russell IV, D.D.S.
• Mark Salenga
• Anika Powell Shaw, LCSW
• Silas D&a Enterprises LLC (SDA Learning Center)
• Antoinette Yvette Silas
• Anne Elizabeth Siler, PHARMD

• General Practice Dentistry in Brownsville, TN
• Providers in Brownsville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.