Benjamin T Russell, DMD

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

D8729 Issued in OR

Practice address

742 NE Division St Ste 102
Gresham, OR 97030-3979

Phone

(503) 667-2442

NPI assigned

Dec 8, 2006

Last updated

Jul 17, 2019By the provider in NPPES

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)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benjamin T Russell DMD LLC

  • Dental Clinic/Center
  • Gresham, OR
  • NPI 1881247039
  NPD Authorized official

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

{
    "created_epoch": "1165536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563321600000",
    "number": "1922168343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "363 SE 4TH AVE",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971234281",
            "telephone_number": "503-756-9046"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "742 NE DIVISION ST STE 102",
            "city": "GRESHAM",
            "state": "OR",
            "postal_code": "970303979",
            "telephone_number": "503-667-2442"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2824 NE Wasco St Ste 230",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972321772",
            "country_code": "US",
            "telephone_number": "503-954-1372",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "363 SE 4th Ave",
            "address_purpose": "LOCATION",
            "city": "Hillsboro",
            "state": "OR",
            "postal_code": "971234281",
            "country_code": "US",
            "telephone_number": "503-756-9046",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUSSELL",
        "first_name": "BENJAMIN",
        "middle_name": "T",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-08",
        "last_updated": "2019-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OR",
            "license": "D8729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Arlo Roy Rudy
• Delia Yulisa Ruiz
• David William Rumer, COMS
• Elena Runyon
• Scott Alan Ruplin, MSW
• Jill Gigi Russell, M.S/CCC-SLP
• Mackenzie Russell, SLP
• Tamekio Russell
• Demetria Lavette Rutledge, APRN-C
• Ryan Douglas Glover Armworks Hand Therapy (Gresham Armworks Hand Therapy)

• Periodontics in Gresham, OR
• Providers in Gresham, OR by specialty
• Periodontics in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.