Carl M. Russell, DMD, PHD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

11115 Issued in GA

Practice address

6488 Hickory Flat Hwy
Canton, GA 30115-7235

Phone

(770) 720-8138

Fax

(770) 720-7580

NPI assigned

Mar 4, 2006

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

Enrolled in GA

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

Credentials

Doctor of Philosophy

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.

• Hickory Flat Orthodontics, PC

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Canton, GA
  • NPI 1952520751
  NPD (past) Authorized official

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

{
    "created_epoch": "1141430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1902873276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6488 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157235",
            "telephone_number": "770-720-8138",
            "fax_number": "770-720-7580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6488 HICKORY FLAT HWY",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301157235",
            "telephone_number": "770-720-8138",
            "fax_number": "770-720-7580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "CARL",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DMD, PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-04",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "GA",
            "license": "11115",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Ruello, PT, DPT
• Jose Benjamin Ruiz-Lagos, M.D.
• Jordan S Rush, MD
• Kristen Marie Rusher
• Andrea W. Russell, D.M.D.
• William Dirk Russell, D.M.D.
• James Michael Rutherford, CRNA
• Terri Rybak, CST/CSFA
• Samuel M Sabaka, PH.D.
• Najam Sabreen, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Canton, GA
• Providers in Canton, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.