Kathy Russell, DDS
Individual provider Active NPI Dentist · Linden, TX
NPI 1891877007 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1891877007
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 13129 (TX)
- Practice address
- 103 Church St
Linden, TX 75563 - Phone
- (903) 756-5154
- Fax
- (903) 756-3995
- NPI assigned
- Oct 19, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13129 | TX | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13129 | TX | Yes |
Addresses
Primary practice location
103 Church St
Linden, TX 75563
Mailing address
PO Box 1349
Linden, TX 75563
Phone (903) 756-7721
Other names
- Kathy Whatley Russell
Other providers in Linden, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.