NPIMap

Organization Active NPI

Michael Russo DDS Susan E Scharlock DDS

  • General Practice Dentistry
  • West Chester, PA
National Provider Identifier
1992914063
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS024419L Issued in PA
Legal business name
MICHAEL RUSSO DDS SUSAN E SCHARLOCK DDS
Practice address
2 Circle Ave
West Chester, PA 19382-4808
Phone
(610) 696-1025
Fax
(610) 696-1058
NPI assigned
May 22, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Russo, DDSNPI 1568840601
Title
Dentist Owner
Phone
(610) 696-1025

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DS024419L PA Primary

Addresses

Primary practice location

2 Circle Ave
West Chester, PA 19382-4808

Mailing address

1039 General Lafayette Blvd
West Chester, PA 19382-8084
Phone (610) 793-0525

National Provider Directory

National Provider Directory

Locations

2 Circle Ave
West Chester, PA 19382
Phone (610) 696-1025

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992914063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1039 GENERAL LAFAYETTE BLVD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193828084",
            "telephone_number": "610-793-0525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 CIRCLE AVE",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193824808",
            "telephone_number": "610-696-1025",
            "fax_number": "610-696-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL RUSSO DDS SUSAN E SCHARLOCK DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RUSSO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "DENTIST OWNER",
        "authorized_official_telephone_number": "610-696-1025",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024419L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.