JUSTIN RUSSO DDS PA NPI 1346732674

NPI Information

  • NPI: 1346732674
  • Provider Name: JUSTIN RUSSO DDS PA
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Doing Business As: RUSSO DENTISTRY
  • Address: 3811 ED DR STE 120
    RALEIGH, NC
    ZIP 27612
  • Phone: (919) 890-5147

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NPI Details

JUSTIN RUSSO DDS PA is a dental clinic center in Raleigh, NC. JUSTIN RUSSO DDS PA NPI is 1346732674. The provider is registered as an organization entity type.
The provider Is Doing Business As Russo Dentistry.

The provider's business location address is:

3811 ED DR STE 120
RALEIGH, NC
ZIP 27612
Phone: (919) 890-5147

The provider's authorized official is Justin Russo .
The authorized official title is Owner and has the following contact phone number (919) 890-5147.

The enumeration date for this NPI number is 6/1/2018 and was last updated on 3/20/2019.

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
1261QD0000XClinic/CenterDentalYes

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

NPI Synchronization or Removal

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