RUSSELL E. GILLIOM, D.D.S., P.C. (NPI# 1902021827) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1902021827 |
Entity Type | Organization |
Organization Name | RUSSELL E. GILLIOM, D.D.S., P.C. |
Practice Address |
230 E Whitley St Churubusco IN 46723-1506 |
Mailing Address |
Po Box 265 Churubusco IN 46723-0265 |
Practice Telephone | 2606932177 |
Practice Fax Number | 2606936422 |
Mailing Telephone | 2606932177 |
Mailing Fax Number | 2606936422 |
Enumeration Date | 2007-04-16 |
Last Update Date | 2020-08-22 |
Authorized Official Name | DR. RUSSELL E. GILLIOM (PRESIDENT) |
Authorized Official Telephone | 2606932177 |
Authorized Official Credential | D.D.S. |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QD0000X |
Clinic/Center Specialization: Dental |
54000935A | IN | Ambulatory Health Care Facilities |
Street Address |
230 E WHITLEY ST |
City | CHURUBUSCO |
State | IN |
Zip Code | 46723-1506 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1699792622 | Dionne Justine Hladin | Dentist | 230 E Whitley St, Churubusco, IN 46723-1506 | 2006-07-16 |
1558710939 | Emily Berning Johnson | Dentist | 230 E Whitley St, Churubusco, IN 46723-1506 | 2016-06-07 |
1336310218 | Churubusco Family Dentistry, LLC | Clinic/Center | 230 E Whitley St, Churubusco, IN 46723-1506 | 2008-03-18 |
1417172321 | Russell Eric Gilliom | Dentist | 230 E Whitley St, Churubusco, IN 46723-1506 | 2007-04-16 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1144348202 | Voca of Indiana LLC | Intermediate Care Facility, Mentally Retarded | 5990 E 500 North, Churubusco, IN 46723 | 2007-03-27 |
1962562637 | Churubusco Family Medicine & Urgent Care | Family Medicine | 202 West Whitley Street, Churubusco, IN 46723 | 2006-12-11 |
1972622413 | Smith Green Community Schools | Local Education Agency (LEA) | 222 W Tulley St, Churubusco, IN 46723-1414 | 2007-03-28 |
1508082272 | Richard Edward Zollinger | Dentist | 230 E Whitley St # 265, Churubusco, IN 46723-1506 | 2007-04-18 |
1235148115 | Kimberly Lou Sajdak | Chiropractor | 208 E Whitley St, Churubusco, IN 46723-1506 | 2006-08-07 |
1205132537 | Biddle Chiropractic, P.C. | Chiropractor | 208 E Whitley St, Churubusco, IN 46723-1506 | 2011-02-03 |
1639178619 | David Allen Johnson | Family Medicine | 4084 North U.s Hwy 33, Churubusco, IN 46723-1700 | 2005-07-20 |
1356622542 | Susan Schowe | Nurse Practitioner | 202 W Whitley St, Churubusco, IN 46723-1720 | 2011-09-01 |
1992783294 | David W. Bolinger | Dentist | 210 W Whitley St, Churubusco, IN 46723-1720 | 2006-01-06 |
1891218137 | Turtle Town Dental LLC | Clinic/Center | 210 W Whitley St, Churubusco, IN 46723-1720 | 2017-07-19 |
Find all providers in zip 46723 |
Taxonomy Code | 261QD0000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Dental |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891218137 | Turtle Town Dental LLC | Clinic/Center | 210 W Whitley St, Churubusco, IN 46723-1720 | 2017-07-19 |
1336310218 | Churubusco Family Dentistry, LLC | Clinic/Center | 230 E Whitley St, Churubusco, IN 46723-1506 | 2008-03-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134720147 | Ms Vibbert Dds PC | Clinic/Center | 7301 Georgetown Rd Ste 113, Indianapolis, IN 46268-4157 | 2020-11-05 |
1508471814 | White River Family Dental and Implant Center | Clinic/Center | 1638 W Smith Valley Rd Ste B, Greenwood, IN 46142-1550 | 2020-09-14 |
1669087144 | Babb Dentistry LLC | Clinic/Center | 2229 W Virginia St, Evansville, IN 47712-5214 | 2020-09-11 |
1790398451 | Bryant P. Burkett Dds, LLC | Clinic/Center | 5310 Pearl Dr Ste C, Evansville, IN 47712-8105 | 2020-08-24 |
1508478298 | Verity Smile Studio, LLC | Clinic/Center | 1619 W. 86th St Suite B, Indianapolis, IN 46260 | 2020-08-23 |
1831701044 | Tree of Life LLC | Clinic/Center | 311 Florence Ave, Granger, IN 46530-8049 | 2020-08-19 |
1568073096 | Fdg Mobile | Clinic/Center | 438 S Emerson Ave Ste 231, Greenwood, IN 46143-1948 | 2020-08-10 |
1992315980 | Kaszuba Dental, LLC | Clinic/Center | 1934 45th St, Munster, IN 46321-3917 | 2020-08-04 |
1205454014 | Advanced Dental Care of Fortville, LLC | Clinic/Center | 545 Vitality Dr Ste F, Fortville, IN 46040-1373 | 2020-07-08 |
1366066375 | Jindal Management LLC | Clinic/Center | 701 N Weinbach Ave Ste 910, Evansville, IN 47711-6607 | 2020-06-05 |
Find all providers with the same taxonomy |
City | CHURUBUSCO |
Zip Code | 46723 |
Please comment or provide details below to improve the information on RUSSELL E. GILLIOM, D.D.S., P.C..
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.