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General NPI Number Information
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NPI Number | 1609797208
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Entity Type | Organization
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Legal Business Name | FIONA RUSS, RDHAP, PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 07/22/2026
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Last Update Date | 07/22/2026
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Provider Practice Location Address
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Address Line | 5424 BULLPEN DR
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City | FONTANA
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State | CA
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Zip | 92336-0141
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Country | US
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Telephone | 909-680-8835
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Fax |
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Provider Business Mailing Address
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Address Line | 5424 BULLPEN DR
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City | FONTANA
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State | CA
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Zip | 92336-0141
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Country | US
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Telephone | 909-680-8835
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | FIONA RUSS
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Credential | RDHAP
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Telephone | 909-680-8835
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number |
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License Number State |
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