PETER ANTHONY RUSSO D.D.S. NPI 1104846849

NPI Information

  • NPI: 1104846849
  • Provider Name: PETER ANTHONY RUSSO, D.D.S.
  • Classification: Dentist - 1223P0300X
  • Specialization: Periodontics
  • Entity Type: Individual
  • Address: 18800 MAIN ST
    STE. 201
    HUNTINGTON BEACH, CA
    ZIP 92648
  • Phone: (714) 842-2515

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NPI Details

Peter Anthony Russo, D.D.S. is a periodontics dentist in Huntington Beach, CA. The provider is 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. Peter Anthony Russo, D.D.S. NPI is 1104846849. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

18800 MAIN ST
STE. 201
HUNTINGTON BEACH, CA
ZIP 92648-707
Phone: (714) 842-2515
Fax: (714) 847-7075

The enumeration date for this NPI number is 7/19/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223P0300XDentistPeriodontics41127CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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