Provider Demographics
NPI:1609836352
Name:CYPHERS, RUSSELL W (DDS)
Entity Type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:W
Last Name:CYPHERS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16620 N 40TH ST
Mailing Address - Street 2:SUITE G-1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-3348
Mailing Address - Country:US
Mailing Address - Phone:602-996-9022
Mailing Address - Fax:602-788-9216
Practice Address - Street 1:16620 N 40TH ST
Practice Address - Street 2:SUITE G-1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-3348
Practice Address - Country:US
Practice Address - Phone:602-996-9022
Practice Address - Fax:602-788-9216
Is Sole Proprietor?:No
Enumeration Date:2006-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3639122300000X
IDD-1907122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist