DR. JUSTIN RUSSO D.D.S.
NPI 1205149275
Dentist - General Practice in Raleigh, NC

Q: What is Justin Russo's NPI number?

The NPI number for Justin Russo is 1205149275. It was assigned to this individual provider in the NPPES registry on July 20, 2010.

Q: What is Justin Russo's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Justin Russo was last updated on March 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since July 20, 2010

3811 ED DR STE 120, RALEIGH, NC 27612(919) 890-5147(919) 890-5953 Get Directions Write a Review

NPPES record last updated: March 20, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Justin Russo D.d.s. NPPES

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

DR. JUSTIN RUSSO D.D.S. (NPI 1205149275) is an individual general practice provider in Raleigh, North Carolina, licensed in North Carolina (9061) and active in the NPI registry since July 2010.

NPPES Registry Identity

NPI1205149275

Entity TypeIndividualMale

Primary Taxonomy1223G0001X

Provider Legal NameDR. JUSTIN RUSSOCredential: D.D.S.

Location Address3811 ED DR STE 120Raleigh, NC 27612-2393

Mailing Address3811 Ed Dr Ste 120Raleigh, NC 27612-2393 · (919) 890-5147 · Fax (919) 890-5953

Phone(919) 890-5147

Fax(919) 890-5953

Sole ProprietorYes

Enumeration DateJuly 20, 2010

Last NPPES UpdateMarch 20, 2019

✔ NPI 1205149275 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

Licenses✔ Licensed in NC · 9061✔ Licensed in PA · DS039342

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.

3811 ED DR STE 120, Raleigh, NC 27612

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Delta Dental of North Carolina, Humana.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.

JUSTIN RUSSO DDS PA

Clinic/Center (Dental)

3811 ED DR STE 120
RALEIGH, NC 27612

Wake County (919) 890-5147

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 Justin Russo's NPI number?

The NPI number for Justin Russo is 1205149275. It was assigned to this individual provider in the NPPES registry on July 20, 2010.

Where is Justin Russo located?

Justin Russo practices at 3811 Ed Dr Ste 120, Raleigh, NC 27612. The listed phone number is (919) 890-5147.

What is Justin Russo's specialty?

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

What insurance does Justin Russo accept?

Health plans from Delta Dental of North Carolina and Humana list Justin Russo 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 Justin Russo was last updated on March 20, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.