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General NPI Number Information
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NPI Number | 1932105087
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Entity Type | Individual
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Provider Name | RUSSELL K TANKERSLEY D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 06/23/2005
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 8305 WALNUT HILL LN STE 230
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City | DALLAS
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State | TX
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Zip | 75231-4260
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Country | US
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Telephone | 214-368-5224
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Fax | 214-368-1740
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Provider Business Mailing Address
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Address Line | 8305 WALNUT HILL LN STE 230
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City | DALLAS
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State | TX
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Zip | 75231-4260
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Country | US
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Telephone | 214-368-5224
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Fax | 214-368-1740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 15877
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 427
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | 12440
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 126800000X
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Taxonomy Name | Dental Assistant
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License Number |
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License Number State | TX
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