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Deactivated NPI 1336121334 Deactivated / Inactive NPI Male Practitioner

Dr. Joseph P. Russo , DDS

Dentist - General Practice • Wakefield, MA

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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. Joseph Russo has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 16, 2005
NPI Deactivation Date March 01, 2021
Total Practice Duration ~16 Years of Practice (2005 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Joseph Russo, DDS was a registered Dentist - General Practice practicing in Wakefield, MA. Throughout an active medical career spanning 16 years, Dr. Russo provided care at the practice location at 15 W WATER ST until profile deactivation on 2021-03-01.

Practice Location & Contact Primary Location

Practice Address

15 W Water St

Wakefield, MA 018802914

Telephone 7812454400
Fax 7812454400
Associated Practice Facility / Clinic
🏢 Joseph P. Russo, D.d.s. Pc Facility NPI 1285783902

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Wakefield, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
21 Specialists

Practicing in Wakefield, MA (3722 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 MA 12262

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 March 01, 2021

Record deactivated on March 01, 2021

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 15 W WATER ST, WAKEFIELD, MA 018802914 (Tel: 7812454400)

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Updated Business Mailing Address July 08, 2007

Registered at 15 W WATER ST, WAKEFIELD, MA 018802914 (Tel: 7812454400)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JOSEPH RUSSO, D.D.S.

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

Dentist (License #12262 in MA)

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Initial NPI Registration & Enumeration November 16, 2005

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: 1336121334
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 16, 2005
Last Update: July 08, 2007
Deactivation Date: March 01, 2021

Mailing Address

15 W Water St

Wakefield, MA 018802914

Phone: 7812454400

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.