DR. EDWARD NICHOLAS RUSSO (NPI# 1003954215) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003954215 |
| Entity Type | Individual |
| Full Name | DR. EDWARD NICHOLAS RUSSO |
| Credential | DMD |
| Practice Address |
2171 Jericho Turnpike Suite # 145 Commack NY 11725 |
| Practice Telephone | 6314626888 |
| Practice Fax Number | 6314990775 |
| Enumeration Date | 2007-02-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
040596 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639197122 | Edward Russo Jr. | Dentist | 5665 Fieldcrest Dr, Scottsville, VA 24590-3886 | 2006-07-17 |
| Street Address |
2171 JERICHO TURNPIKE SUITE # 145 |
| City | COMMACK |
| State | NY |
| Zip Code | 11725 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780778282 | Robert Alan Poch | Dentist | 2171 Jericho Turnpike, Commack, NY 11725 | 2006-10-02 |
| 1275014136 | Mindful Therapy Lcsw, Pllc | Social Worker | 2171 Jericho Turnpike, Suite 335, Commack, NY 11725 | 2018-08-28 |
| 1447382577 | Jill Kofler | Counselor | 2171 Jericho Turnpike, Suite 335, Commack, NY 11725 | 2007-03-12 |
| 1578620225 | Marc Harris Grusensky | Psychiatry & Neurology | 2171 Jericho Turnpike, Suite 210, Commack, NY 11725 | 2007-01-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699322131 | Amanda Grace Acebedo | Student in an Organized Health Care Education/Training Program | 785 Larkfield Rd, Commack, NY 11725 | 2019-08-20 |
| 1922667716 | Diana Mcnamara | Social Worker | 13 Audrey Lane, Commack, NY 11725 | 2019-06-06 |
| 1821504333 | Amy Koenig | Specialist | 787 Larkfield Rd, Commack, NY 11725 | 2017-12-19 |
| 1437661501 | Commack Chemist Inc | Pharmacy | 6216 Jericho Turnpike, Commack, NY 11725 | 2017-10-30 |
| 1285168880 | Stephanie Arico | Counselor | 14 Silver Pond Cir, Commack, NY 11725 | 2017-04-20 |
| 1235684432 | Ams Primary Medical Care House Calls,pc | Home Health | 6277 Jericho Tpk, Commack, NY 11725 | 2016-08-18 |
| 1376927459 | Min Sun Park | Dentist | All About Smiles Pediatric Dentistry, 5036 Jericho Turnpike Suite #307, Commack, NY 11725 | 2015-07-17 |
| 1467843748 | Joanna Keegan | Pharmacy Technician | 98 Veterans Memorial Highway, Commack, NY 11725 | 2015-02-09 |
| 1275936841 | Jennie Bernstein | Social Worker | 368 Veterans Hwy Ste 2, Commack, NY 11725 | 2014-09-26 |
| 1417362021 | Diana Matira Yildirim | Pediatrics | 646 Commack Road, Commack, NY 11725 | 2014-06-23 |
| Find all providers in zip 11725 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922152404 | Steven Craig Hill | Dentist | 2171 Jericho Turnpike Suite #145, Commack, NY 11725 | 2007-01-22 |
| 1770570962 | Commack Endodontics PC | Dentist | 164 Commack Rd, Ste #7, Commack, NY 11725-3430 | 2005-10-03 |
| 1700279239 | Commack Dental Design Pllc | Dentist | 283 Commack Rd, Suite 120, Commack, NY 11725-6021 | 2015-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063026235 | Sanghyun Park | Dentist | 1103 Stewart Ave Ste 104, Garden City, NY 11530-4886 | 2020-09-03 |
| 1164031654 | Harp Endodontics PC | Dentist | 121 E 60th St Apt 10a, New York, NY 10022-1198 | 2020-07-30 |
| 1518590918 | All County Endodontics, PC | Dentist | 112 Westminster Rd, Scarsdale, NY 10583-2425 | 2020-02-14 |
| 1245862325 | Marie Milagros Mora Moreno | Dentist | 345 E 24th St Dept Of, New York, NY 10010-4020 | 2020-02-06 |
| 1407406218 | Geoffrey Louis Sas | Dentist | 1414 Avenue of The Americas Fl 19, New York, NY 10019-2514 | 2019-09-13 |
| 1790340875 | Kim & Wang Dds Pllc | Dentist | 10737 71st Ave Ste 203, Forest Hills, NY 11375-4736 | 2019-05-05 |
| 1003373903 | Prohealth Dental Pllc | Dentist | 5011 Vernon Blvd, Long Island City, NY 11101 | 2019-02-27 |
| 1023575982 | Prohealth Dental Pllc | Dentist | 16345 Crossbay Blvd, Howard Beach, NY 11414-3741 | 2019-02-27 |
| 1114494911 | Alf Hitel Bunes | Dentist | 900 Starboard Side Ln Apt 306, Webster, NY 14580-2288 | 2018-10-30 |
| 1972086684 | Steven Kyongmin Kim | Dentist | 209 E 56th St Frnt 1, New York, NY 10022 | 2018-09-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.