BILLY DALE RUSSOM (NPI# 1114013067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114013067 |
| Entity Type | Individual |
| Full Name | BILLY DALE RUSSOM |
| Credential | D.D.S. |
| Practice Address |
211 Hospital Dr Corning AR 72422-7259 |
| Mailing Address |
Po Box 435 Corning AR 72422-0435 |
| Practice Telephone | 8708573557 |
| Practice Fax Number | 8708575128 |
| Mailing Telephone | 8708573557 |
| Mailing Fax Number | 8708575128 |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
AR2169 | AR | Dental Providers |
| Street Address |
211 HOSPITAL DR |
| City | CORNING |
| State | AR |
| Zip Code | 72422-7259 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639326341 | Michele Ann Crancer | Speech-Language Pathologist | 510 Wynn Park Drive, Corning, AR 72422 | 2008-08-25 |
| 1639104920 | Stacy R Arnell | Social Worker | 602 David Street, Corning, AR 72422 | 2006-07-12 |
| 1285046896 | Krystal Dawn Upshaw | Podiatrist | 1300 Creason Rd, Corning, AR 72422 | 2014-06-02 |
| 1760803241 | Kristen Nicole Bruce | Counselor | 602 David St, Corning, AR 72422 | 2013-12-30 |
| 1316211469 | Lisa Lynn Vinal | Nurse Practitioner | 1300 Creason Rd, Corning, AR 72422 | 2012-03-06 |
| 1538431556 | Susie Elaine Flanery | Social Worker | 1300 Creason Rd, Corning, AR 72422 | 2012-02-07 |
| 1023230661 | Corning Public Schools | Local Education Agency (LEA) | 500 Bobcat Lane, Corning, AR 72422-0479 | 2007-05-03 |
| 1003951278 | Karen R Crawley | Speech-Language Pathologist | 2503 Cherry St, Corning, AR 72422-1315 | 2007-02-21 |
| 1649821844 | Jill Ann Foster | Nurse's Aide | 301 Griggs Ln, Corning, AR 72422-1425 | 2019-09-28 |
| 1700211489 | Bradley Chiropractic Center, LLC | Chiropractor | 301 N Missouri Ave, Suite 17, Corning, AR 72422-1600 | 2013-09-12 |
| Find all providers in zip 72422 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528398815 | Dennis Vargas | Dentist | 218 Denison Pkwy E Ste 1, Corning, NY 14830-2813 | 2010-01-08 |
| 1861690984 | John Wallace Gunselman | Dentist | 218 Denison Pkwy E, Suite 201, Corning, NY 14830-2813 | 2007-07-10 |
| 1720283757 | Maria Del Rosario Reyna Fuller | Dentist | 2244 Loomis Ave, Corning, IA 50841 | 2007-06-19 |
| 1275659856 | Dario Abramo Sartori | Dentist | 480 Solano St, Corning, CA 96021-3433 | 2007-03-22 |
| 1700930880 | Richard Bond Dunbar | Dentist | 1904 Solano St, Corning, CA 96021-2831 | 2007-01-23 |
| 1902954324 | Donald Richard Dolan Jr. | Dentist | 169 E 2nd St, Corning, NY 14830-2836 | 2007-01-08 |
| 1336213057 | Robert Gerard Wylie | Dentist | 182 E 1st St, Corning, NY 14830-2816 | 2006-11-17 |
| 1215012109 | John T King | Dentist | 504 8th Street, Corning, IA 50841-1404 | 2006-10-26 |
| 1083714695 | John Kevin Sementilli | Dentist | 92 E 1st St, Corning, NY 14830-2714 | 2006-09-24 |
| 1710995766 | John David Richardson II | Dentist | 421 Sw 2nd St, Corning, AR 72422-2708 | 2006-08-04 |
| Find all providers in CORNING | ||||
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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.