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SHARON RUSSELL DDS PC NPI 1386073054


NPI Information

NPI: 1386073054
Provider Name: SHARON RUSSELL DDS PC

Doing Business As: THE MARYLAND ORAL SURGERY GROUP

Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
9632 MARLBORO PIKE
MELWOOD PROFESSIONAL CENTER
UPPER MARLBORO, MD
ZIP 20772
Phone: (240) 320-7331
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SHARON RUSSELL DDS PC is a general practice dentist in Upper Marlboro, MD. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. SHARON RUSSELL DDS PC NPI is 1386073054. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Maryland Oral Surgery Group.

The provider's business location address is:

9632 MARLBORO PIKE
MELWOOD PROFESSIONAL CENTER
UPPER MARLBORO, MD
ZIP 20772-670
Phone: (240) 320-7331

The provider's authorized official is Mark Russell .
The authorized official title is Coo and has the following contact phone number (240) 320-7331.

The enumeration date for this NPI number is 11/4/2013 and was last updated on 11/4/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1122300000XDentist14351MARYLANDNo
21223P0700XDentistProsthodonticsNo
31223G0001XDentistGeneral Practice14351MARYLANDYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
114351MEDICAIDMARYLAND

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: 4/28/2024

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