Active NPI
Russell Paul Umbricht, DDS
- Dentist
- River Forest, IL
National Provider Identifier
1922265933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 19A13481
- Practice address
- 404 Lathrop Ave
River Forest, IL 60305-1810 - Phone
- (708) 366-8909
- Fax
- (708) 366-8909
- NPI assigned
- May 19, 2008
- Last updated
- May 19, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19A13481 | IL | Primary |
Addresses
Primary practice location
404 Lathrop Ave
River Forest, IL 60305-1810
Mailing address
404 Lathrop Ave
River Forest, IL 60305-1810
Phone (708) 366-8909
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19A13481 | IL | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Russell P Umbricht DDS LTD | Dentist | Past | Accepting new patients |
| Global Facial Aesthetics PC | Dentist | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dentist
- River Forest, IL
- NPI 1659753481
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211155200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211155200000",
"number": "1922265933",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "404 LATHROP AVE",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051810",
"telephone_number": "708-366-8909",
"fax_number": "708-366-8909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "404 LATHROP AVE",
"city": "RIVER FOREST",
"state": "IL",
"postal_code": "603051810",
"telephone_number": "708-366-8909",
"fax_number": "708-366-8909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UMBRICHT",
"first_name": "RUSSELL",
"middle_name": "PAUL",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-05-19",
"last_updated": "2008-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "19A13481",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in River Forest, IL
- Fred M Tomera, MD
- Mark Tomera, MD
- Daniel G. Torres, M.D.
- Elizabeth Treatman, M.A., CCC-SLP
- Robin Ann Uchitelle, MD
- Jillian Breann Vander Pol, RN, WHNP
- Gabriela Velazquez
- VHS Acquisition Subsidiary Number 4 Inc (River Forest Breast Care Center)
- VHS Acquisition Subsidiary Number 4 Inc (River Forest Advanced Imaging Center)
- VHS Acquisition Subsidiary Number 4 Inc (River Forest Cardiovascular Center)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.