KEITH EDMUND RUSSELL (NPI# 1447328752) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447328752 |
| Entity Type | Individual |
| Full Name | KEITH EDMUND RUSSELL |
| Credential | DMD |
| Practice Address |
495 Woodford St Portland ME 04103-2438 |
| Practice Telephone | 2077726966 |
| Mailing Telephone | 2077726966 |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 3414 | ME | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | INDIVIDUAL TAX ID # | 043377401 | 01 |
| ME | 264030099 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326335886 | Keith Perry Russell | Radiology | 200 State Highway 30 W, New Albany, MS 38652-3112 | 2011-07-06 |
| 1275798480 | Keith Russell | Physical Therapist | 1330 E Arlington Blvd, Suite A, Greenville, NC 27858-7850 | 2008-07-28 |
| 1023239662 | Keith Duncan Russell | Social Worker | 20816 E 11 Mile Rd, Suite 113, Saint Clair Shores, MI 48081-1565 | 2007-05-01 |
| 1730270018 | Keith Wayne Russell | Psychiatry & Neurology | 1200 Ne 13th St, Oklahoma City, OK 73152-3277 | 2006-09-28 |
| Street Address |
495 WOODFORD ST |
| City | PORTLAND |
| State | ME |
| Zip Code | 04103-2438 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659449940 | Regan & Russell, LLC. | Dentist | 495 Woodford St, Portland, ME 04103-2438 | 2006-12-03 |
| 1851459838 | Dorothy Jean Regan | Dentist | 495 Woodford St, Portland, ME 04103-2438 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790302677 | Hope for All Community Services LLC | Community/Behavioral Health | 68 Bishop St, Building 1, Unit 1, Portland, ME 04103 | 2020-06-26 |
| 1982251435 | Hope Home Healthcare, LLC | Home Health | 68 Bishop St Unit 3 #2, Portland, ME 04103 | 2019-08-20 |
| 1992367023 | Care for Everyone | In Home Supportive Care | 68 Bishop Street, Unit 1, Room 5, Portland, ME 04103 | 2019-06-28 |
| 1093373458 | Emanuel Nistrian | Student in an Organized Health Care Education/Training Program | Une, 716 Stevens Ave., Portland, ME 04103 | 2019-05-31 |
| 1023676483 | Robert Montague | Student in an Organized Health Care Education/Training Program | University of New England, 716 Stevens Ave, Portland, ME 04103 | 2019-05-31 |
| 1154838027 | Kimberly Therriault | Behavior Technician | 527 Ocean Ave Ste 19, Portland, ME 04103 | 2018-01-02 |
| 1285147918 | Teresa Maalouf | Community Health Worker | 23 Cambridge St., Portland, ME 04103 | 2017-11-16 |
| 1578082244 | Darcelle Kay Stillman | Occupational Therapist | 90 Dorothy St, Portland, ME 04103 | 2017-09-14 |
| 1821524943 | Engility Enterprises LLC | Case Management | 1 Coast Lane, Portland, ME 04103 | 2017-05-10 |
| 1720524283 | Hannah Rose Kazilionis | Counselor | 257 Deering Ave # 204, Portland, ME 04103 | 2017-01-09 |
| Find all providers in zip 04103 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598366064 | Felipe Gregorio Flores | Dentist | 107 Shorecliff Dr, Portland, TX 78374-1459 | 2020-11-02 |
| 1972117588 | Medical Teams International | Dentist | 14150 Sw Milton Ct, Portland, OR 97224-8024 | 2020-09-01 |
| 1255975561 | Michigan Sleep Solutions LLC | Dentist | 8037 Abbey Rd., Portland, MI 48875-9774 | 2019-10-30 |
| 1073162699 | Ryan Douglas Mccormick | Dentist | 3620 Se Powell Blvd Ste 200, Portland, OR 97202-1880 | 2019-09-06 |
| 1255989497 | Owen Ritter Lund | Dentist | 4224 Ne Halsey St Ste 330, Portland, OR 97213-1568 | 2019-08-30 |
| 1023663119 | Xiaochen Zhou | Dentist | 2824 Ne Wasco St Ste 200, Portland, OR 97232-1772 | 2019-08-06 |
| 1598223919 | Portland Modern Dentistry | Dentist | 5175 Ne Martin Luther King Blvd Ste 110, Portland, OR 97211-3233 | 2019-03-05 |
| 1922571942 | Rashmi, LLC | Dentist | 553 Portland Cobalt Rd Unit 1, Portland, CT 06480-1968 | 2019-01-03 |
| 1053891051 | Waleed Almulla | Dentist | 8401 Ne Halsey St Ste 102, Portland, OR 97220-5670 | 2018-08-19 |
| 1558848333 | Kelsey Mcevoy | Dentist | 11805 Nw Cedar Falls Dr Ste 101, Portland, OR 97229-2780 | 2018-07-24 |
| Find all providers in PORTLAND | ||||
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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.