Individual
DR. WILLARD DEAN RUSSELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
2483
WV
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
6261
MD
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS030508L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0136408000
—
WV
01
—
066637
TRIGON
—
01
—
DF52
BCBS MD
MD
01
—
LK72
DENTAL/MEDICAL
MD
Enumeration date
10/23/2006
Last updated
05/30/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up