Robert Ruel Russell, DMD, MD

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

License

MD28928 Issued in OR

Practice address

911 Main St
Suite 180
Oregon City, OR 97045-1867

Phone

(503) 650-6116

Fax

(503) 650-6198

NPI assigned

May 8, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 1, 2016 through Sep 1, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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.

• Humble Richmond & Russell Oral & Maxillofacial Surgery, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Oregon City, OR
  • NPI 1770887648
  NPD (past)

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

{
    "created_epoch": "1178582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1243900800000",
    "number": "1861605487",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 MAIN ST",
            "address_2": "SUITE 180",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451867",
            "telephone_number": "503-650-6116",
            "fax_number": "503-650-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "911 MAIN ST",
            "address_2": "SUITE 180",
            "city": "OREGON CITY",
            "state": "OR",
            "postal_code": "970451867",
            "telephone_number": "503-650-6116",
            "fax_number": "503-650-6198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROBERT",
        "middle_name": "RUEL",
        "name_prefix": "Dr.",
        "credential": "DMD, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-08",
        "last_updated": "2009-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "21510",
            "primary": false
        },
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "OR",
            "license": "MD28928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kailee Loretta Rothi
• Lorena Rousseau
• Rebecca Monique Ruiz, LPC, CADC-I
• Mary Rumbaugh
• Ron Rushlight
• Marianne Russo
• Jerry David Ryan, LPC.CRC.NCC,MS
• Marcella Ryan
• Kelly William Rydlund, MD
• Matthew Sablay

• Oral & Maxillofacial Surgery (D.M.D.) in Oregon City, OR
• Providers in Oregon City, OR by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2009; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.