Roxann Russell, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DN18794 Issued in FL

Practice address

16688 N. Dale Mabry Hwy
Tampa, FL 33618

Phone

(813) 374-9695

Fax

(813) 333-7323

NPI assigned

Jul 21, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Roxann Russell Aves Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1483056000000",
    "number": "1922029347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16688 N. DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-374-9695",
            "fax_number": "813-333-7323"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16688 N. DALE MABRY HWY",
            "city": "TAMPA",
            "state": "FL",
            "postal_code": "33618",
            "telephone_number": "813-374-9695",
            "fax_number": "813-333-7323"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "ROXANN",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-21",
        "last_updated": "2016-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MO",
            "license": "016103",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "17627",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "FL",
            "license": "DN18794",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000084500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ROXANN",
            "last_name": "AVES",
            "middle_name": "RUSSELL",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Delaney Ann Russell, PA-C
• Elisabeth Marie Russell, PT, DPT
• Joshua Russell
• Judy Ann Russell, ARNP
• Kirsten Russell, MD
• Sean Russell, CRNA
• Sharon S Russell, ARNP-C
• Stephen Forrest Russell, PHD
• William John Russell, PT
• Flor Russello, ARNP

• Pediatric Dentistry in Tampa, FL
• Providers in Tampa, FL by specialty
• Pediatric Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2016; 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.