RUSSOMANNO KEANE DDS PA
NPI 1720697808
Dentist - General Practice in Maplewood, MN

Active since July 24, 2020
1975 11TH AVE E, MAPLEWOOD, MN 55109(651) 770-2900 Get Directions Write a Review

NPPES record last updated: July 24, 2020. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Russomanno Keane Dds Pa NPPES

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

RUSSOMANNO KEANE DDS PA (NPI 1720697808), doing business as Bluejay Family Dentistry, is a healthcare organization registered as a general practice in Maplewood, Minnesota and active in the NPI registry since July 2020. The organization lists Sam Jacobson, Business Manager, as its authorized official.

NPPES Registry Identity

NPI1720697808
Entity TypeOrganization
Primary Taxonomy1223G0001X
Legal Business NameRUSSOMANNO KEANE DDS PA
Location Address1975 11TH AVE EMaplewood, MN 55109-5148
Mailing Address8910 Penn Ave SBloomington, MN 55431-2025 · (952) 881-0504
Organization SubpartNo
Authorized OfficialSam JacobsonBusiness Manager · (651) 307-4966
Enumeration DateJuly 24, 2020
NPPES CertifiedJuly 24, 2020
NPI 1720697808 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.

1975 11TH AVE E, Maplewood, MN 55109

Other Names 1

Doing Business AsBluejay Family Dentistry

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

Other Providers at the Same Location NPPES 3

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

Clinic/Center (Dental)
1975 11TH AVE E
MAPLEWOOD, MN 55109
Dentist (General Practice)
1975 11TH AVE E
MAPLEWOOD, MN 55109
Dentist
1975 11TH AVE E
MAPLEWOOD, MN 55109

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 Russomanno Keane Dds PA's NPI number?

The NPI number for Russomanno Keane Dds PA is 1720697808. It was assigned to this organization in the NPPES registry on July 24, 2020. The provider is doing business as Bluejay Family Dentistry.

Where is Russomanno Keane Dds PA located?

Russomanno Keane Dds PA is located at 1975 11th Ave E, Maplewood, MN 55109. The listed phone number is (651) 770-2900.

What is Russomanno Keane Dds PA's specialty?

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

What insurance does Russomanno Keane Dds PA accept?

Health plans from UnitedHealthcare list Russomanno Keane Dds PA 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 Russomanno Keane Dds PA was last updated on July 24, 2020. NPI Profile syncs with the weekly NPPES data releases published by CMS.