DR. RANDALL J RUSSELL (D.D.S.) – Oral and Maxillofacial Surgery (Dentist), NPI 1013170968

DR. RANDALL J RUSSELL (D.D.S.) is a healthcare provider. based in Centennial, Colorado. specializing in ORAL SURGERY. They hold the professional credentials D.D.S.. They hold a License No. DEN.00201913 (CO). The NPI Number for DR. RANDALL J RUSSELL (D.D.S.) is 1013170968

Main info

Male
Sole Proprietor
18 Years Of Experience
Accepts Medicare Assignment
Name
DR. RANDALL J RUSSELL (D.D.S.)
NPI
1013170968
Phone
(720) 870-1451
Address
20971 E SMOKY HILL RD
Enumeration Date
9 July 2008
Last Update Date
11 March 2013

Doctor Profile

Medical School Name
VIRGINIA COMMONWEALTH UNIV SCHOOL OF DENTISTRY
Secondary Phone
7202251000
Graduation Year
2008 (18 years ago)
PAC ID
9931415783
Group Practice PAC ID
1951559293
Professional Enrollment ID
I20160205001433
Address ID
CO801245522LO10101PKWY300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:17State licenses:1Digital endpointsOther names

29 ORAL SURGERY in CO

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Provider Addresses for DR. RANDALL J RUSSELL (D.D.S.)

  • Bridges Center, 20971, East Smoky Hill Road, Centennial, Arapahoe County, Colorado, 80015, United States

    SUITE 201

    CENTENNIAL, CO 800155186

    Phone: (720) 870-1451

    Fax: (720) 870-1456

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $108.

Total Amount is formed as General ($108) + Research ($0) + Ownership ($0) = $108.

Last reported payment date: 2024-10-24 • Largest payer in this snapshot: ZIMVIE INC. ($92).

Total Amount

$108

General + Research + Ownership

Payments

7

Total payment records

General Amount

$108

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-24

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2016-02-05

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20160205001433IOral SurgeryCOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 80015)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951559293View full group profile
NameSpecialtyState
U R O L O G YCO
Otolaryngology, Plastic And Reconstructive SurgeryCO
Urology, General SurgeryCO
O P H T H A L M O L O G YCO
Oral SurgeryCO
Oral Surgery, Maxillofacial SurgeryCO
Nurse PractitionerCO
O T O L A R Y N G O L O G YIL
O P H T H A L M O L O G YGA
O P H T H A L M O L O G YCO

Reviews

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Frequently asked questions

Can I cross-check DR. RANDALL J RUSSELL (D.D.S.) using NPI 1013170968?
NPI 1013170968 belongs to DR. RANDALL J RUSSELL (D.D.S.); compare other details if you need extra assurance.
Is there an active status for DR. RANDALL J RUSSELL (D.D.S.)?
For scheduling context, DR. RANDALL J RUSSELL (D.D.S.) is shown as active in the registry.
What kind of doctor is DR. RANDALL J RUSSELL (D.D.S.)?
DR. RANDALL J RUSSELL (D.D.S.) is associated with Oral and Maxillofacial Surgery (Dentist) in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for DR. RANDALL J RUSSELL (D.D.S.)?
Travel planning: use Centennial, Colorado as the reference point for DR. RANDALL J RUSSELL (D.D.S.), then confirm.
Does DR. RANDALL J RUSSELL (D.D.S.) accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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