Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
TRAVIS ANDRE RUSSELL, DDS
ActiveDental Public Health · CONCORD, NC
Registration Details
- NPI Number
- 1861976839
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 17, 2018 (7.5936906366144 yrs)
- Last Updated
- Feb 20, 2026
- License
-
9255 (SC)
Practice Information
- Address
-
280 CONCORD PKWY S STE 110ACONCORD, NC, 280272704Browse NC providers · Browse ZIP 28027
- Phone
- 7049201070
- Fax
- 7049201071
- Primary Specialty
-
Dental Public Health
1223D0001X
Other Dental Public Health Providers in CONCORD, NC
| Name | Credential | NPI |
|---|---|---|
| TASHANA DETWILER | DMD | 1205500147 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.