DR. MARILYN A. RUSSELL (NPI# 1912025784) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1912025784 |
| Entity Type | Individual |
| Full Name | DR. MARILYN A. RUSSELL |
| Credential | DMD |
| Practice Address |
2844 Lake Park Dr Jonesboro GA 30236-4133 |
| Mailing Address |
105 Carnegie Pl Suite 113 Fayetteville GA 30214-3980 |
| Practice Telephone | 7704788459 |
| Practice Fax Number | 7704786026 |
| Mailing Telephone | 6788170600 |
| Mailing Fax Number | 6788170601 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2007-07-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
008294 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760710552 | Marilyn Russell | Licensed Practical Nurse | 2250 Hickory Rd, Plymouth Meeting, PA 19462-1047 | 2009-12-07 |
| 1477628030 | Marilyn Stewart Russell | Social Worker | 12557 Ravenwood Dr, Chardon, OH 44024-9009 | 2006-11-21 |
| Street Address |
2844 LAKE PARK DR |
| City | JONESBORO |
| State | GA |
| Zip Code | 30236-4133 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972123362 | Life Source Counseling & Consulting, LLC | Clinic/Center | 118 North Avenue, Suite A, Jonesboro, GA 30236 | 2020-04-25 |
| 1639609555 | New Beginnings Behavioral Counseling,llc | Social Worker | 9456 S Main St Ste E2, Jonesboro, GA 30236 | 2017-06-13 |
| 1437696762 | Clarissa Alexandra Poole | Counselor | 2106 Fair Ridge Ct, Jonesboro, GA 30236 | 2017-01-25 |
| 1588012892 | Sundance Healthcare Service Inc | In Home Supportive Care | 7861 Collinswood Court, Jonesboro, GA 30236 | 2016-05-26 |
| 1942669205 | Adrianne Smiley Gurley | Occupational Therapist | 1299 Battlecreek Rd Ste 210, Jonesboro, GA 30236 | 2016-02-15 |
| 1336505809 | Integrated Health Center | Dentist | 8600 Tara Blvd, Suite D, Jonesboro, GA 30236 | 2016-01-13 |
| 1467827402 | Surrell Porter | Nurse Practitioner | 1287 Georgia Highway 138 Spur, Suite 8, Jonesboro, GA 30236 | 2015-12-02 |
| 1740688910 | Jacqueline Carolyn Edwards | Registered Nurse | 8081 Tara Blvd, 265, Jonesboro, GA 30236 | 2014-12-19 |
| 1770991861 | Lower Extremity Diagnostics, LLC | Podiatrist | 6911 Tara Boulevard, Jonesboro, GA 30236 | 2014-08-01 |
| 1760899710 | Fresenius Medical Care Jonesboro, LLC | Clinic/Center | 8060 Summitt Business Parkway, Jonesboro, GA 30236 | 2014-07-22 |
| Find all providers in zip 30236 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780772962 | Michael L. Thompson | Dentist | 2737 Paula Dr, Jonesboro, AR 72404-8017 | 2006-10-11 |
| 1972508117 | Barry Zeitman | Dentist | 405 Arrowhead Blvd, Jonesboro, GA 30236-1254 | 2005-06-15 |
| 1619403615 | Thomas M Jackson | Dentist | 2737 Paula Dr, Jonesboro, AR 72404-8017 | 2017-05-11 |
| 1457667115 | Michael L. Thompson, Ms, Dds, Pllc | Dentist | 2737 Paula Dr, Jonesboro, AR 72404-8017 | 2010-08-19 |
| 1134275910 | Karen Samuels Horace | Dentist | 6568 Tara Boulevard, Jonesboro, GA 30236 | 2007-01-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801420146 | Scott Hansen Lowry | Dentist | 1430 John Wesley Drive, Augusta, GA 30912-0001 | 2020-02-25 |
| 1780233981 | North Point Periodontics Center LLC | Dentist | 4205 N Point Pkwy Ste A, Alpharetta, GA 30022-8808 | 2019-09-10 |
| 1972012961 | Newnan Periodontics LLC | Dentist | 1635 Highway 34 E Ste A, Newnan, GA 30265-2173 | 2017-09-22 |
| 1871948695 | Kyle Garrett | Dentist | 2704 W Terrace Dr, Augusta, GA 30909-3622 | 2016-04-29 |
| 1346601291 | Titanium Dental | Dentist | 3796 Satellite Blvd Ste 101, Duluth, GA 30096-5698 | 2016-03-18 |
| 1073972584 | Kara Kramer | Dentist | 2970 Peachtree Rd Nw Ste 622, Atlanta, GA 30305-2115 | 2016-02-12 |
| 1922491356 | John H Eaton | Dentist | 1776 Old Spring House Ln Ste 301, Dunwoody, GA 30338-6225 | 2015-03-10 |
| 1679977656 | M Forest Butler Dds Ms PC | Dentist | 320 Killian Hill Rd Nw, Lilburn, GA 30047-3809 | 2014-10-20 |
| 1790196467 | Wranglehurst, P.C. | Dentist | 3850 Holcomb Br. Rd, Suite 230, Norcross, GA 30092 | 2014-05-15 |
| 1699104927 | Nisha Maniar Kancherla | Dentist | 300 W Wieuca Rd Ne Suite 100, Atlanta, GA 30342-9701 | 2013-11-07 |
| Find all providers with the same taxonomy | ||||
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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.