Dr Willard Dean Russell Jr, DDS - Dentist in Martinsburg, WV

Dr Willard Dean Russell Jr, DDS is a Dentist - Oral And Maxillofacial Surgery based in Martinsburg, West Virginia. Dr Willard Dean Russell Jr is licensed to practice in West Virginia (license number 2483) and his current practice location is 1007 Sushruta Drive, Martinsburg, West Virginia. He can be reached at his office (for appointments etc.) via phone at (304) 263-0991.

NPI number for Dr Willard Dean Russell Jr is 1215010285 and his current mailing address is 1007 Sushruta Drive, Martinsburg, West Virginia. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1215010285.

Contact Information

Dr Willard Dean Russell Jr, DDS
1007 Sushruta Drive,
Martinsburg, WV 25401
(304) 263-0991
(304) 274-9546

Map and Direction




Healthcare Provider's Profile

Full NameDr Willard Dean Russell Jr
GenderMale
SpecialityDentist - Oral And Maxillofacial Surgery
Location1007 Sushruta Drive, Martinsburg, West Virginia
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1215010285
  • Provider Enumeration Date: 10/23/2006
  • Last Update Date: 05/30/2012

Medical Identifiers

Medical identifiers for Dr Willard Dean Russell Jr such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1215010285NPI-NPPES
066637OtherTRIGON
0136408000MedicaidWV
DF52OtherMDBCBS MD
LK72OtherMDDENTAL/MEDICAL

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223S0112XDentist - Oral And Maxillofacial Surgery 2483 (West Virginia)Primary
1223S0112XDentist - Oral And Maxillofacial Surgery 6261 (Maryland)Secondary
1223S0112XDentist - Oral And Maxillofacial Surgery DS030508L (Pennsylvania)Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Willard Dean Russell Jr is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Willard Dean Russell Jr, DDS
1007 Sushruta Drive,
Martinsburg, WV 25401

Ph: (304) 263-0991
Dr Willard Dean Russell Jr, DDS
1007 Sushruta Drive,
Martinsburg, WV 25401

Ph: (304) 263-0991

Reviews and Comments


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