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Deactivated NPI 1114013067 Deactivated / Inactive NPI Male Practitioner

Dr. Billy Dale Russom , DDS

Dentist - General Practice • Corning, AR

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Billy Russom has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date October 05, 2006
NPI Deactivation Date February 26, 2026
Total Practice Duration ~20 Years of Practice (2006 – 2026)

Professional Overview & Biography Verified Profile Summary

Dr. Billy Russom, DDS was a registered Dentist - General Practice practicing in Corning, AR. Throughout an active medical career spanning 20 years, Dr. Russom provided care at the practice location at 211 HOSPITAL DR until profile deactivation on 2026-02-26.

Practice Location & Contact Primary Location

Practice Address

211 Hospital Dr

Corning, AR 724227259

Telephone 8708573557
Fax 8708575128
Associated Practice Facility / Clinic
🏢 Billy D Russom, Dds Facility NPI 1609471499

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Corning, AR

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 25.0 Yrs
Regional Practice Density
2 Specialists

Practicing in Corning, AR (909 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License AR AR2169

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.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated February 26, 2026

Record deactivated on February 26, 2026

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 211 HOSPITAL DR, CORNING, AR 724227259 (Tel: 8708573557)

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Updated Business Mailing Address July 08, 2007

Registered at PO BOX 435, CORNING, AR 724220435 (Tel: 8708573557)

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Provider Name / Credentials Updated July 08, 2007

Recorded as BILLY RUSSOM, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #AR2169 in AR)

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Initial NPI Registration & Enumeration October 05, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1114013067
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 05, 2006
Last Update: July 08, 2007
Deactivation Date: February 26, 2026

Mailing Address

Po Box 435

Corning, AR 724220435

Phone: 8708573557

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.