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RUSSELL MODERN DENTISTRY, PC
NPI 1063173466
Dentist - General Practice in Portland, OR

Active since January 07, 2022
1710 NE 122ND AVE, PORTLAND, OR 97230(503) 295-2120(503) 305-3342 Get Directions Write a Review

NPPES record last updated: January 7, 2022. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Russell Modern Dentistry, Pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

RUSSELL MODERN DENTISTRY, PC (NPI 1063173466), doing business as Russell Modern Dentistry, is a healthcare organization registered as a general practice in Portland, Oregon and active in the NPI registry since January 2022. The organization lists Sumeet S. Pandhoh, Owner, as its authorized official.

NPPES Registry Identity

NPI1063173466
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameRUSSELL MODERN DENTISTRY, PC
Location Address1710 NE 122ND AVEPortland, OR 97230-1939
Mailing AddressPo Box 920050Dallas, TX 75392-0050 · (714) 845-8890
Phone(503) 295-2120
Fax(503) 305-3342
Organization SubpartNo
Authorized OfficialSumeet S. PandhohOwner · (503) 295-2120
Enumeration DateJanuary 7, 2022
NPPES CertifiedJanuary 7, 2022
✔ NPI 1063173466 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
1710 NE 122ND AVE, Portland, OR 97230
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Other Names 1

Doing Business AsRussell Modern Dentistry

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include UnitedHealthcare.Insurance ›

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KAYLA ELLIS DDS
Dentist (General Practice)
1710 NE 122ND AVE
PORTLAND, OR 97230
Multnomah County (503) 295-2120

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Russell Modern Dentistry, PC's NPI number?

The NPI number for Russell Modern Dentistry, PC is 1063173466. It was assigned to this organization in the NPPES registry on January 7, 2022. The provider is doing business as Russell Modern Dentistry.

Where is Russell Modern Dentistry, PC located?

Russell Modern Dentistry, PC is located at 1710 NE 122nd Ave, Portland, OR 97230. The listed phone number is (503) 295-2120.

What is Russell Modern Dentistry, PC's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

What insurance does Russell Modern Dentistry, PC accept?

Health plans from UnitedHealthcare list Russell Modern Dentistry, PC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Russell Modern Dentistry, PC was last updated on January 7, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.