MILLIE DEAN RUSSELL


Address: 12058 San Jose Blvd, #102, Jacksonville, FL 32223-8666
Phone: 9048803131

MILLIE DEAN RUSSELL (NPI# 1649502006) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1649502006
Entity Type Individual
Full Name MILLIE DEAN RUSSELL
Credential D.D.S.
Practice Address 12058 San Jose Blvd
#102
Jacksonville
FL 32223-8666
Practice Telephone 9048803131
Practice Fax Number 9048803169
Mailing Telephone 9048803131
Mailing Fax Number 9048803169
Enumeration Date 2010-02-09
Last Update Date 2011-09-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 122300000X Dentist DS13804 FL Dental Providers

Other Providers MILLIE RUSSELL

NPI Name Taxonomy Address Enumeration
1154986032 Millie D Russell Case Manager/Care Coordinator 2005 Mclain St, Newport, AR 72112-3662 2019-05-06

Office Location

Street Address 12058 SAN JOSE BLVD
#102
City JACKSONVILLE
State FL
Zip Code 32223-8666

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730182940 Lynda R. Mance Social Worker 12058 San Jose Blvd, Suite 703, Jacksonville, FL 32223-8666 2005-05-23
1992298921 Christina R Lee Social Worker 12058 San Jose Blvd, Jacksonville, FL 32223-8666 2018-06-13
1114266731 Christan Bennett Brooks Social Worker 12058 San Jose Blvd, Ste 104, Jacksonville, FL 32223-8669 2013-02-01
1164651220 Nancy Ann Busch Social Worker 12058 San Jose Blvd, Ste 703, Jacksonville, FL 32223-8666 2009-07-10
1922288364 Krantz Dental Care, P.a. Dentist 12058 San Jose Blvd, Suite 102, Jacksonville, FL 32223-8666 2007-11-13
1811187271 Mandarin Counseling Inc Social Worker 12058 San Jose Blvd, Ste 703, Jacksonville, FL 32223-8666 2007-07-31
1780736983 Jacqueline Boudreau Viola Social Worker 12058 San Jose Blvd, Suite 703, Jacksonville, FL 32223-8666 2007-01-17
1356455000 Luis E. Quinones, Md, Pa Psychiatry & Neurology 12058 San Jose Blvd, Suite 903, Jacksonville, FL 32223-1842 2006-08-19
1871509810 Rosalind Ann Heller-slevin Nurse Practitioner 12058 San Jose Blvd, Suite1003, Jacksonville, FL 32223-8666 2006-07-31
1851338818 Luis E. Quinones Psychiatry & Neurology 12058 San Jose Blvd, Suite 903, Jacksonville, FL 32223-1842 2006-05-31
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1679103600 Karen Gabriela Alexander Dietitian, Registered Ackerman Cancer Center, 10881 San Jose Blvd, Jacksonville, FL 32223 2020-01-17
1891250049 Thalia L Honea Occupational Therapist 12766 San Jose Blvd, Suite 716 & 717, Jacksonville, FL 32223 2019-02-01
1447758289 Stephanie Ann Murphy Marriage & Family Therapist 11543 Halethorpe Drive, Jacksonville, FL 32223 2018-01-26
1861948481 Nicole Gay Developmental Therapist 12276 San Jose Blvd, Ste 5, Jacksonville, FL 32223 2016-09-01
1740694439 Robyn K Mizelle Behavioral Analyst 12276 San Jose Blvd. Great Strides Rehabilitation, Suite 507, Jacksonville, FL 32223 2014-06-20
1184038010 Kelli Anne Cabrera Occupational Therapist 12350 San Jose Blvd, Jacksonville, FL 32223 2014-06-18
1891031910 Mandarin Family Medicine, P.a. Preferred Provider Organization 12276-210 San Jose Blvd, Jacksonville, FL 32223 2012-12-18
1114201811 Darshana Choksi Pharmacist 3663 Marbon Rd, Jacksonville, FL 32223 2011-09-30
1346539988 Harris Wilcox and Donovan Pa Optometrist 11790 San Jose Bl, Jacksonville, FL 32223 2011-04-05
1740517796 Beth A. Kelley Occupational Therapist 2640 Scott Mill Dr, Jacksonville, FL 32223 2009-11-12
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Taxonomy Information

Taxonomy Code 122300000X
Grouping Dental Providers
Classification Dentist

Taxonomy Definition

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

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902419864 Andre M Fang Dentist 6801 Roosevelt Blvd, Jacksonville, FL 32212-1192 2020-08-28
1952911752 Jeff Woohyeok Chang Dentist 964 Ajax Street, Jacksonville, FL 32212 2020-08-06
1093323479 Britney Marie Cruz Dentist 1280 Western Blvd Unit 200, Jacksonville, NC 28546-7658 2020-07-21
1083238786 Sleep Better Solutions LLC Dentist 4215 Southpoint Blvd Ste 240, Jacksonville, FL 32216-0932 2020-05-29
1114550258 James Moran Dentist 7990 Baymeadows Rd E # 718, Jacksonville, FL 32256-2961 2020-02-18
1265075329 Latoya Goins Dentist 1280 Western Blvd, Jacksonville, NC 28546-6653 2019-10-22
1437706462 Stephanie Marquez Dentist 751 Oak St Ste 601, Jacksonville, FL 32204-3373 2019-08-23
1831751064 Rachel Marie Schloth Dentist 12086 Fort Caroline Rd Ste 105, Jacksonville, FL 32225-2688 2019-07-09
1598324113 Dhaval Yogeshkumar Shah Dentist 8206 Philips Hwy., Suite 21, Jacksonville, FL 32256 2019-06-07
1235796954 Carolina Garcia Dentist 790 Skymarks Dr Ste 109, Jacksonville, FL 32218-7267 2019-05-29
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 32223

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Dataset Information

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.

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