location
search-icon
person
Dr. Samuel Yohannes Russom, DDS
Pediatric Dentist in Chula Vista, California
NPI 1144719196

Samuel Yohannes Russom is a Pediatric Dentist based in San Diego, CA and is specialized in Pediatric Dentistry. Samuel Yohannes Russom practices in Chula Vista, CA and has the professional credentials of DDS. The NPI Number for Samuel Yohannes Russom is 1144719196 and holds a License No. DDS104651 (California).

The current practice location address for Samuel Yohannes Russom is 2015 Birch Rd Ste 103, Chula Vista, CA and can be reached out via phone at 619-391-9287.

Location: 2015 Birch Rd Ste 103, Chula Vista, CA, 92105-4959
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144719196
Provider Name
Samuel Yohannes Russom
Credential
DDS
Provider Entity Type
Individual
Gender
Male
Address
2015 Birch Rd Ste 103, Chula Vista, CA, 92105-4959
Phone Number
619-391-9287
Fax Number
Provider Enumeration Date
05/04/2018
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
2015 Birch Rd Ste 103
City
Chula Vista
State
California
Zip
91915-2003
Phone Number
619-391-9287
Fax Number
person
Provider Business Mailing Address Details
Address
2015 Birch Rd Ste 103
City
Chula Vista
State
California
Zip
91915-2003
Phone Number
619-391-9287
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
DDS104651 (California)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
semi-verified symbol
Badge

Use the following badge on your website to showcase your NPI number and verified status. In a field with over 8 million healthcare providers in the United States, it is important to establish your identity clearly. Displaying this badge signifies that your information is both accurate and up-to-date.