RUSSELL KENT SEARLE (NPI# 1881829257) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881829257 |
| Entity Type | Individual |
| Full Name | RUSSELL KENT SEARLE |
| Credential | DMD |
| Practice Address |
10590 Enduring Freedom Dr Fort Drum NY 13602-5503 |
| Mailing Address |
4431 68th St Us Army Dental Activity - Attn: Tatiana Slaughter Fort Hood TX 76544-5042 |
| Practice Telephone | 3157726234 |
| Mailing Telephone | 2542872705 |
| Mailing Fax Number | 2542871786 |
| Enumeration Date | 2009-05-28 |
| Last Update Date | 2019-07-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | 09194 | OR | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
D9194 | OR | Dental Providers |
| Street Address |
10590 ENDURING FREEDOM DR |
| City | FORT DRUM |
| State | NY |
| Zip Code | 13602-5503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578621769 | Keith Jonathan Wilson | Dentist | 10590 Enduring Freedom Dr, Us Army Dental Activity, Fort Drum, NY 13602-5005 | 2006-12-04 |
| 1669087771 | Mitchell Garrett Lamb | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503 | 2020-09-15 |
| 1356955603 | Euris Miguel Mieses | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503 | 2020-09-03 |
| 1003464009 | Jacob Miller Allen | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503 | 2019-09-03 |
| 1568957694 | Sarah Marie Mcsherry | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503 | 2018-07-01 |
| 1134614563 | Jacob D Woodward | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5503 | 2018-06-27 |
| 1821500802 | Bianca Garcia | Dental Hygienist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2017-10-30 |
| 1265976328 | Hye H Kim | Dentist | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-12-08 |
| 1467803338 | Dennis Nicholson | Dental Assistant | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-22 |
| 1841649530 | Julie Wainwright | Dental Assistant | 10590 Enduring Freedom Dr, Fort Drum, NY 13602-5005 | 2016-06-03 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235697590 | Joshua Lee Hickman | Physician Assistant | Bldg P10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2019-03-06 |
| 1447721345 | Lisa Marie Lewis | Social Worker | 11044 Mount Belvedere Blvd, Fort Drum, NY 13602 | 2018-12-17 |
| 1720555253 | Elizabeth M Hover | Social Worker | P11050 Mt Belvedere Blvd, Fort Drum, NY 13602 | 2018-11-02 |
| 1376037424 | Phillip Dakotah Mitchell | Physician Assistant | 10020 Euphrates River Valley Road, Fort Drum, NY 13602 | 2018-06-20 |
| 1063902666 | Guthrie Ahc | Clinic/Center | P19914 M3r Tampa, Fort Drum, NY 13602 | 2018-05-18 |
| 1255846879 | Morgan Elizabeth Callari | Dental Hygienist | 10205 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-12-05 |
| 1609389097 | John Charles Bockmann | Physician Assistant | Connor Troop Medical Clinic, 10506 Euphrates River Valley Rd, Fort Drum, NY 13602 | 2017-11-08 |
| 1902318207 | Nicholas Andrew Jones | Military Health Care Provider | 10506 S. Riva Ridge, Fort Drum, NY 13602 | 2017-10-26 |
| 1508389198 | Richard Scott Christiansen | Physical Therapist | 10330 S Riva Ridge Loop, Fort Drum, NY 13602 | 2017-07-25 |
| 1811418098 | Emer B Bajuelos | Dentist | Ft Drum W07uaa 10590, Ft Drum, Apo, AP 13602 | 2017-06-28 |
| Find all providers in zip 13602 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962487926 | Marvin Paul Anderson | Dentist | Us Army Dental Activity, 10205 N Riva Ridge Loop, Fort Drum, NY 13602-5005 | 2005-12-13 |
| 1316920705 | David Lee Schneck | Dentist | Us Army Dental Activity Attn Credentials Coordinator, 10205 N Riva Ridge Loop, Fort Drum, NY 13602-5005 | 2005-11-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053921643 | Upper West Side Oral & Maxillofacial Surgery | Dentist | 140 W 69th St Ph 1g, New York, NY 10023-5173 | 2020-08-07 |
| 1467092965 | Nyc Implant and Oral Surgery PC | Dentist | 30 E 60th St Ste 907, New York, NY 10022-1058 | 2020-01-13 |
| 1235777566 | Asnis Dental Pllc | Dentist | 800 Woodbury Rd Ste C, Woodbury, NY 11797-2503 | 2019-12-17 |
| 1700420429 | Chavkin Oral and Maxillofacial Surgery LLC | Dentist | 414 Jericho Tpke Ste 2, New Hyde Park, NY 11040-4510 | 2019-11-06 |
| 1730737545 | Southwoods Boulevard Dental, P.C. | Dentist | 7 Southwoods Blvd Ste 1, Albany, NY 12211-2526 | 2019-08-27 |
| 1750947792 | Eduard Munarov Dds PC | Dentist | 449 N State Rd Ste 102, Briarcliff Manor, NY 10510-1478 | 2019-05-15 |
| 1598227530 | Asnis Dental Pllc | Dentist | 250 Patchogue Yaphank Rd Ste 10, East Patchogue, NY 11772-4862 | 2019-04-01 |
| 1720545387 | Asnis Dental, Pllc | Dentist | 260 Middle Country Rd Ste 12, Selden, NY 11784-2570 | 2019-03-01 |
| 1205344819 | Ray Cheng Dds | Dentist | 217 Park Row Ste 4b, New York, NY 10038-1101 | 2018-01-17 |
| 1871006064 | Ny Oral and Maxillofacial Surgeon, PC | Dentist | 2844 Ocean Pkwy Ste B2, Brooklyn, NY 11235-7904 | 2017-11-09 |
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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.