Russel Dasalla, DMD in San Fernando, CA - Medicare Dentist Provider

Russel Dasalla, DMD is a medicare enrolled "Dentist - General Practice" provider in San Fernando, California. His current practice location is 12898 Adelphia Ave, San Fernando, California. You can reach out to his office (for appointments etc.) via phone at (818) 350-3212.

Russel Dasalla is licensed to practice in California (license number 64643) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1336524305.

Contact Information

	Russel Dasalla, DMD
	12898 Adelphia Ave, San Fernando, CA 91340-1047
	(818) 350-3212
	Not Available

Healthcare Provider's Profile

Full Name	Russel Dasalla
Gender	Male
Speciality	Dentist - General Practice
Location	12898 Adelphia Ave, San Fernando, California
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1336524305
Provider Enumeration Date: 07/20/2015
Last Update Date: 07/20/2015

Medicare PECOS Information:

PECOS PAC ID: 8123336609
Enrollment ID: I20151002000574

Medical Identifiers

Medical identifiers for Russel Dasalla such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1336524305	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	64643 (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. Russel Dasalla 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
Russel Dasalla, DMD 12898 Adelphia Ave, San Fernando, CA 91340-1047 Ph: (818) 350-3212	Russel Dasalla, DMD 12898 Adelphia Ave, San Fernando, CA 91340-1047 Ph: (818) 350-3212

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Dentist in San Fernando, CA

Dr. Paul W Riley, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 400 N Maclay Ave, San Fernando, CA 91340 Phone: 818-361-4084 Fax: 818-365-6112
Shabnam Dastmalchian, Dentist Medicare: Not Enrolled in Medicare Practice Location: 326 N Maclay Ave, San Fernando, CA 91340 Phone: 818-898-9990 Fax: 818-898-9992
Dr. Yoly Malanyaon Estrada, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 451 S Brand Blvd, 206, San Fernando, CA 91340 Phone: 818-838-7030 Fax: 818-838-7003
Dr. Maria Eloisa Ilagan, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 556 S Brand Blvd, San Fernando, CA 91340 Phone: 818-365-3004 Fax: 818-365-7100
Dr. Clifford K Oyama, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 412 San Fernando Mission Blvd, San Fernando, CA 91340 Phone: 818-365-3934
Dr. Ryan Zhong-wei Huang I, DDS Dentist Medicare: Medicare Enrolled Practice Location: 1600 San Fernando Rd, San Fernando, CA 91340 Phone: 818-898-1388 Fax: 818-270-9570
Yesenia R Estremodoyro, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 11380 Laurel Canyon Blvd, San Fernando, CA 91340 Phone: 822-581-2870

Russel Dasalla, DMD - Medicare Dentist in San Fernando, CA