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Samuel Russom, DDS
NPI 1144719196 · Pediatric Dentistry · Chula Vista, CA
Samuel Russom, DDS is a Pediatric Dentistry provider in Chula Vista, CA (NPI 1144719196).
Provider details
- NPI number
- 1144719196
- Entity type
- Individual
- Primary specialty
- Pediatric DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- DDS104651 (CA)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(68/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2015 Birch Rd Ste 103
Chula Vista, CA 91915-2003
Phone: (619) 391-9287
Street-level locationGet directions
Mailing address
5311 Oak Park Dr
San Diego, CA 92105-4959
Registry dates
- Enumerated
- 2018-05-04
- Last updated
- 2021-12-28
- Certified
- 2021-12-28
Frequently asked questions
- What is Samuel Russom's NPI number?
- Samuel Russom's National Provider Identifier (NPI) is 1144719196, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Samuel Russom's specialty?
- Samuel Russom is listed in the NPPES registry with a primary specialty of Pediatric Dentistry (Dental Providers).
- Where is Samuel Russom located?
- Samuel Russom's practice location on file with NPPES is 2015 Birch Rd Ste 103, Chula Vista, CA 91915-2003.
- What is Samuel Russom's phone number?
- The practice phone number listed in the NPPES registry for Samuel Russom is (619) 391-9287.
- Is Samuel Russom's NPI active?
- Yes — Samuel Russom's NPI (1144719196) is active in the NPPES registry as of the last update on 2021-12-28.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.