Nicholas Vito Russo, D.D.S.

Dentist · Brookfield, WI

Individual Active NPI

NPI number 1063811297

Practice location

12690 W North Ave
Brookfield, WI 53005-4636
Phone
(262) 784-3740

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NPI record

NPI
1063811297
Entity type
Individual (Type 1)
Enumeration date
August 13, 2014
Last updated
February 9, 2016
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 1000994-15 WI

About Dr. Russo

Nicholas Vito Russo, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 12690 W North Ave, Brookfield, WI 53005-4636. The NPI number 1063811297 was assigned on August 13, 2014 and the record was last updated on February 9, 2016.

Dr. Russo lists a license in the registry: #1000994-15 (WI) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Nicholas Vito Russo, D.D.S.?

The NPI number is 1063811297.

What is the phone number of Dr. Russo?

The phone number listed for the practice location is (262) 784-3740.

Where is Dr. Russo located?

12690 W North Ave, Brookfield, WI 53005-4636.

What is the taxonomy code for Dr. Russo?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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