Travis Andre Russell, DDS in Concord, NC - Medicare Dentist Provider

Travis Andre Russell, DDS is a medicare enrolled "Dentist - Dental Public Health" provider in Concord, North Carolina. His current practice location is 280 Concord Pkwy S Ste 110a, Concord, North Carolina. You can reach out to his office (for appointments etc.) via phone at (704) 920-1070.

Travis Andre Russell is licensed to practice in South Carolina (license number 9255) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1861976839.

Contact Information

	Travis Andre Russell, DDS
	280 Concord Pkwy S Ste 110a, Concord, NC 28027-2704
	(704) 920-1070
	(704) 920-1071

Map and Direction

Healthcare Provider's Profile

Full Name	Travis Andre Russell
Gender	Male
Speciality	Dentist - Dental Public Health
Location	280 Concord Pkwy S Ste 110a, Concord, North Carolina
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1861976839
Provider Enumeration Date: 09/17/2018
Last Update Date: 02/20/2026

Medicare PECOS Information:

PECOS PAC ID: 9830443597
Enrollment ID: I20181115000922

Medical Identifiers

Medical identifiers for Travis Andre Russell such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1861976839	NPI	-	NPPES
ZX9255	Medicaid	SC

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223D0001X	Dentist - Dental Public Health	9255 (South Carolina)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Travis Andre Russell allows following entities to bill medicare on his behalf.

Entity Name	Caresouth Carolina Inc.
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1720082571 PECOS PAC ID: 1052221314 Enrollment ID: O20040511000280

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Travis Andre Russell is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Travis Andre Russell, DDS 300 Mooresville Rd, Kannapolis, NC 28081-0304 Ph: (704) 920-1070	Travis Andre Russell, DDS 280 Concord Pkwy S Ste 110a, Concord, NC 28027-2704 Ph: (704) 920-1070

Reviews and Comments

Dentist in Concord, NC

Dr. Darnell Gregory, D.D.S. Dentist Medicare: Not Enrolled in Medicare Practice Location: 8815 Christenbury Pkwy Ste 40, Concord, NC 28027 Phone: 704-264-0253
Dr. Dennis Raymond Lockney, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 219 Branchview Dr Ne, Concord, NC 28025 Phone: 704-788-4144 Fax: 704-788-4199
Dr. Eleanor Steel, D.M.D., M.P.H. Dentist Medicare: May Accept Medicare Assignments Practice Location: 280 Concord Pkwy S Ste 110a, Concord, NC 28027 Phone: 704-920-1070 Fax: 704-934-4270
James R Spencer, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 244 Le Phillip Ct, Concord, NC 28025 Phone: 704-786-8317
Darriel Joseph Cannon, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5325 Vinning St Nw Ste 203, Concord, NC 28027 Phone: 704-785-8060
Dr. Bradley Conway, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 1020 Lee Ann Dr Ne, Concord, NC 28025 Phone: 704-795-1055 Fax: 704-795-6743
Dr. Alexandra Damerau Best, DMD, MSD, PA Dentist Medicare: Not Enrolled in Medicare Practice Location: 1028 Lee Ann Dr Ne Ste 300, Concord, NC 28025 Phone: 704-782-5146

Travis Andre Russell, DDS - Medicare Dentist in Concord, NC