Russell Clifford Doeringer, DMD PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901009668 Issued in MI

Practice address

4626 Walton Blvd
Waterford, MI 48329-3535

Phone

(248) 674-0384

Fax

(248) 674-1483

NPI assigned

Jan 3, 2007

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 and National Provider Directory roles.

• Michigan Dental PC

  • General Practice Dentistry
  • Waterford, MI
  • NPI 1215402383
  NPD (past)

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891852083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293535",
            "telephone_number": "248-674-0384",
            "fax_number": "248-674-1483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4626 WALTON BLVD",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483293535",
            "telephone_number": "248-674-0384",
            "fax_number": "248-674-1483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOERINGER",
        "first_name": "RUSSELL",
        "middle_name": "CLIFFORD",
        "name_prefix": "Dr.",
        "credential": "DMD PC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901009668",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kacie Dimmitt
• Helen Dinsmore, L.P.N.
• Divine Resources Consulting, LLC
• Kathleen Michelle Doan, MA LPC NCC
• Emily Doane
• Riley Erin Doetsch
• Prachi Doke Bhole
• Yvonne Marie Dolohanty-Kontny
• Mackenzie Donohue, LLMSW
• Leonard Gordon Dorey, MD

• General Practice Dentistry in Waterford, MI
• Providers in Waterford, MI by specialty
• General Practice Dentistry in Michigan

• 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.