Mr. John Douglas Russell is a Shasta Lake City, California based Dentist who is specialized in
Dentistry. He does not accept the Medicare-approved amount. Patients will be billed for the treatment. Active license number of Mr. John Douglas Russell is
20042 for Dentistry in California. His current practice location is
4178 Ashby Court, Shasta Lake City. Patients can reach him at
530-275-2910.
Mr. John Douglas Russell is the primary dental care provider for patients of all ages. He is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
Complete Profile:
Mr. John Douglas Russell speciality, credentials, practice address, contact phone number and fax are as below.
Patients can directly walk in or can call on the below given phone number for appointment.
| Name: | Mr. John Douglas Russell |
| Specialization: | Dentist |
| Gender: | Male |
| Credentials: | DDS |
| Accepts Medicare Assignment: | No |
| Practice Address: | 4178 Ashby Court, Shasta Lake City,
California, 96019 |
| Phone: | 530-275-2910 |
| Fax: | 530-275-9335 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details are as mentioned below.
| NPI Number: | 1902958077 |
| NPI Enumeration Date: | 17 Jan, 2007 |
| NPI Last Update On: | 08 Jul, 2007 |
Medical Licenses:
Doctors can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Mr. John Douglas Russell are as mentioned below.
| License Number | Specialization | State | Status | |
| 20042 | Dentistry | California | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers associated with Mr. John Douglas Russell such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| B2004201 | Medicaid | California | |
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 4178 Ashby Court,
Shasta Lake City, California |
| Zip: | 96019 |
| Phone Number: | 530-275-2910 |
| Fax Number: | 530-275-9335 |
Patients can reach Mr. John Douglas Russell at
4178 Ashby Court, Shasta Lake City, California or can
call to book an appointment on 530-275-2910.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
09 March, 2026.