Stacey W Russell, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11897 Issued in MD

Practice address

22 Truck House Rd Ste 3
Severna Park, MD 21146-2728

Phone

(410) 647-4269

Fax

(410) 544-5910

NPI assigned

Jan 12, 2012

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 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.

• Cheskis, Hooper, Schatz, Russell & Assc., LLC

  • General Practice Dentistry
  • Severna Park, MD
  • NPI 1629082938
  NPD (past)

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

{
    "created_epoch": "1326326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326326400000",
    "number": "1811267487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 TRUCK HOUSE RD STE 3",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462728",
            "telephone_number": "410-647-4269",
            "fax_number": "410-544-5910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 TRUCK HOUSE RD STE 3",
            "city": "SEVERNA PARK",
            "state": "MD",
            "postal_code": "211462728",
            "telephone_number": "410-647-4269",
            "fax_number": "410-544-5910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "STACEY",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-12",
        "last_updated": "2012-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "11897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Victoria Rogers, LCPC
• Thomas Harlowe Root, PHARMD
• Ross Van Antwerp DO MPH PA Laser Center of Maryland
• Sandra Goody Rosswork, PH.D.
• Rothschild'S Orthopedic Appliances, Inc
• Rutzen Eye Specialists
• Allan R Rutzen, MD
• Briah Leslie Ryan, LCPC
• Shauna Michelle Rykiel, LCSW-C, LCADC
• Bashar Ahmad Sadat, DDS

• General Practice Dentistry in Severna Park, MD
• Providers in Severna Park, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2012; 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.