- Practice location
- 175 Eagle Rock Ave, Roseland, NJ 07068-1321
- Phone
- 973-226-1973
- Fax
- —
- Last updated
- January 22, 2019
Michael Russo is a Dentist based in Roseland, NJ. Michael Russo practices in Roseland, NJ. The NPI Number for Michael Russo is 1932594801 and holds a License No. 22DI02639100 (NJ). The current practice location address for Michael Russo is 175 Eagle Rock Ave, Roseland, NJ 07068-1321 and can be reached out via phone at 973-226-1973.
Provider Profile Details
- NPI Number
- 1932594801
- Provider Name
- Michael Russo
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 175 Eagle Rock Ave, Roseland, NJ 07068-1321
- Phone Number
- 973-226-1973
- Primary Taxonomy
- Dentist · 122300000X
- Sole Proprietor
- No
- Provider Enumeration Date
- March 30, 2015
- Last Update Date
- January 22, 2019
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 175 Eagle Rock Ave
Roseland, NJ 07068-1321 - City
- Roseland
- State
- New Jersey
- Zip
- 07068-1321
- Phone Number
- 973-226-1973
Provider Business Mailing Address Details
- Address
- 175 Eagle Rock Ave
Roseland, NJ 07068-1321 - City
- Roseland
- State
- NJ
- Zip
- 07068-1321
License Information
- License Number
- 22DI02639100
- License State
- NJ
- Taxonomy
- Dentist · 122300000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Dentists near Roseland, NJ
View all Dentists in Roseland →Frequently Asked Questions
What is the NPI number of Michael Russo?
The NPI number of Michael Russo is 1932594801. It was assigned on March 30, 2015 and is currently active in the NPPES registry.
What is the specialty of Michael Russo?
Michael Russo is registered under the primary taxonomy Dentist (code 122300000X), licensed in NJ under license number 22DI02639100.
Where does Michael Russo practice?
The practice location is 175 Eagle Rock Ave, Roseland, NJ 07068-1321. The office can be reached at 973-226-1973 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1932594801 directly on the NPPES registry website.