NPIMap

Organization Active NPI

Gus S. Russo DDS PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Langhorne, PA
National Provider Identifier
1861682460
Registry record updated Jul 30, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DSO19052L Issued in PA
Legal business name
GUS S. RUSSO DDS PC
Practice address
310 Middletown Blvd
The Courtyard at Oxford Valley Ste 202
Langhorne, PA 19047-3203
Phone
(215) 757-0864
Fax
(215) 757-8090
NPI assigned
Jul 30, 2007
Last updated
Jul 30, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2007

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

Authorized official

Name
Dr. Gus S Russo, DDS
Title
President/Owner
Phone
(215) 757-0864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DSO19052L PA Primary

Addresses

Primary practice location

310 Middletown Blvd
The Courtyard at Oxford Valley Ste 202
Langhorne, PA 19047-3203

Mailing address

310 Middletown Blvd
The Courtyard at Oxford Valley Ste 202
Langhorne, PA 19047-3203
Phone (215) 757-0864

National Provider Directory

National Provider Directory

Locations

310 Middletown Blvd
Ste 202
Langhorne, PA 19047
Phone (215) 757-0864

Practitioners & affiliated clinicians

Practitioners 2

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": "1185753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185753600000",
    "number": "1861682460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 MIDDLETOWN BLVD",
            "address_2": "THE COURTYARD AT OXFORD VALLEY STE 202",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190473203",
            "telephone_number": "215-757-0864",
            "fax_number": "215-757-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 MIDDLETOWN BLVD",
            "address_2": "THE COURTYARD AT OXFORD VALLEY STE 202",
            "city": "LANGHORNE",
            "state": "PA",
            "postal_code": "190473203",
            "telephone_number": "215-757-0864",
            "fax_number": "215-757-8090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GUS S. RUSSO DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-30",
        "last_updated": "2007-07-30",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "GUS",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "215-757-0864",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "PA",
            "license": "DSO19052L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Langhorne, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.