DR. NICOLAS HENRY RUSSO DMD NPI 1205812765

NPI Information

NPI: 1205812765
Provider Name: DR. NICOLAS HENRY RUSSO, DMD
Classification: Dentist - 1223P0700X
Entity Type: Individual

Specialization: Prosthodontics

Address:
1 PINCKNEY BLVD
NAVAL HOSPITAL BEAUFORT
BEAUFORT, SC
ZIP 29902
Phone: (843) 228-5577
Get Directions

DR. Nicolas Henry Russo, DMD is a prosthodontics dentist in Beaufort, SC. The provider is that branch of dentistry pertaining to the restoration and maintenance of oral functions, comfort, appearance and health of the patient by the restoration of natural teeth and/or the replacement of missing teeth and contiguous oral and maxillofacial tissues with artificial substitutes. DR. Nicolas Henry Russo, DMD NPI is 1205812765. 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:

1 PINCKNEY BLVD
NAVAL HOSPITAL BEAUFORT
BEAUFORT, SC
ZIP 29902-122
Phone: (843) 228-5577
Fax: (843) 228-5196

The enumeration date for this NPI number is 12/16/2005 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
1	1223P0700X	Dentist	Prosthodontics	039175	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	000OTH	MEDICARE UPIN

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: 5/5/2024

NPI Synchronization or Removal

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