Raymond Rust Jr.

Primary specialty

DentistTaxonomy code 122300000X

License

DE60409006 Issued in WA

Practice address

12 S 8TH St
Yakima, WA 98901-3020

Phone

(509) 454-4143

Fax

(509) 454-4115

NPI assigned

Oct 30, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

State licenses

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 and National Provider Directory roles.

• Yakima Neighborhood Health Services

  dba Neighborhood Health Terrace Heights

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1750985727
  Medicare reassignment NPD
• Yakima Neighborhood Health Services

  dba Neighborhood Connections Annex

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1285456772
  NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1962178988
  NPD
• Yakima Neighborhood Health Services

  • Federally Qualified Health Center (FQHC)
  • Yakima, WA
  • NPI 1225085624
  NPD (past)

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

{
    "created_epoch": "1383091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1932537875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2605",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989072605",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S 8TH ST",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989013020",
            "telephone_number": "509-454-4143",
            "fax_number": "509-454-4115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUST",
        "first_name": "RAYMOND",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-30",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "62794",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60409006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carmen Aurora Rusinaru, PHD
• Delaney Russell
• Elissa S Russell
• Margaret Mary Russell, MD
• Pamela Dawn Russell, LICSW
• Amelia Ariel Rutter, ARNP
• Ryan S. Kezele D.D.S. P.S.
• Blair Ryan
• Jocelyn Michelle Ryan, LMT
• Amanda G Ryder, MD

• Dentist in Yakima, WA
• Providers in Yakima, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2024; 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.