Mr John Douglas Russell, DDS in Shasta Lake City, CA - Dentist

Mr John Douglas Russell, DDS is a Dentist based in Shasta Lake City, California. Mr John Douglas Russell is licensed to practice in California (license number 20042) and his current practice location is 4178 Ashby Court, Shasta Lake City, California. He can be reached at his office (for appointments etc.) via phone at (530) 275-2910.

NPI number for Mr John Douglas Russell is 1902958077 and his current mailing address is 4178 Ashby Court, Shasta Lake City, California. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1902958077.

Contact Information

	Mr John Douglas Russell, DDS
	4178 Ashby Court, Shasta Lake City, CA 96019
	(530) 275-2910
	(530) 275-9335

Healthcare Provider's Profile

Full Name	Mr John Douglas Russell
Gender	Male
Speciality	Dentist
Location	4178 Ashby Court, Shasta Lake City, California
Accepts Medicare Assignments	Does not participate in Medicare Program. He may not accept medicare assignment.

NPI Data:

NPI Number: 1902958077
Provider Enumeration Date: 01/17/2007
Last Update Date: 07/08/2007

Medical Identifiers

Medical identifiers for Mr John Douglas Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1902958077	NPI	-	NPPES
B2004201	Medicaid	CA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	20042 (California)	Primary

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. Mr John Douglas Russell is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Mr John Douglas Russell, DDS 4178 Ashby Court, Shasta Lake City, CA 96019 Ph: (530) 275-2910	Mr John Douglas Russell, DDS 4178 Ashby Court, Shasta Lake City, CA 96019 Ph: (530) 275-2910

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Mr John Douglas Russell, DDS - Dentist in Shasta Lake City, CA