# RUSSELL S TAICHMAN

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1740310473
- **Gender:** Man
- **Credential:** DMD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 2901016167 | MI | Yes |
| 1223P0300X | Periodontics | 2901016167 | MI | — |

## Other

- **Enumeration date:** 03/06/2007
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | D161670 | BCBS OF MICHIGAN | MI |