Dr Elisa Russell, DDS in Moraga, CA - Medicare Dentist Provider

Dr Elisa Russell, DDS is a medicare enrolled "Dentist" provider in Moraga, California. Her current practice location is 1722 Saint Andrews Dr, Moraga, California. You can reach out to her office (for appointments etc.) via phone at (925) 818-0241.

Dr Elisa Russell is licensed to practice in California (license number 25276) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1366568859.

Contact Information

	Dr Elisa Russell, DDS
	1722 Saint Andrews Dr, Moraga, CA 94556-1033
	(925) 818-0241
	Not Available

Healthcare Provider's Profile

Full Name	Dr Elisa Russell
Gender	Female
Speciality	Dentist
Location	1722 Saint Andrews Dr, Moraga, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366568859
Provider Enumeration Date: 03/22/2007
Last Update Date: 10/18/2013

Medicare PECOS Information:

PECOS PAC ID: 3476897695
Enrollment ID: I20181128003646

Medical Identifiers

Medical identifiers for Dr Elisa Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366568859	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	25276 (California)	Primary
1223G0001X	Dentist - General Practice	25276 (California)	Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Elisa Russell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Elisa Russell, DDS 1722 Saint Andrews Dr, Moraga, CA 94556-1033 Ph: (925) 818-0241	Dr Elisa Russell, DDS 1722 Saint Andrews Dr, Moraga, CA 94556-1033 Ph: (925) 818-0241

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Dentist in Moraga, CA

Dr. Kian Tavallaei, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 533 Moraga Road Suite 230, Moraga, CA 94556 Phone: 925-376-0322 Fax: 925-376-0436
Dr. Norman J Hanson, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 3844 Paseo Grande, Moraga, CA 94556 Phone: 925-376-1948
Dr. Scott D Lothamer, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1030 Country Club Drive, Suite F, Moraga, CA 94556 Phone: 925-376-4602 Fax: 925-376-4502
Joseph Zingale, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 236 Sheila Ct, Moraga, CA 94556 Phone: 925-376-9624
Dr. Laura L Halvorsen, Dentist Medicare: Not Enrolled in Medicare Practice Location: 1004 Country Club Dr, Moraga, CA 94556 Phone: 925-376-4626
Dr. Julia Thanh-hai Hoang, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 533 Moraga Rd, Ste 240, Moraga, CA 94556 Phone: 510-847-8455

Dr Elisa Russell, DDS - Medicare Dentist in Moraga, CA