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Dr. Jonathan P Russo , DDS

Dentist β€’ Omaha, NE

Active NPI 1780472308 Individual Practitioner Male Practitioner
Practice location in NPPES

11110 Fort St Ste 106
Omaha, NE 681642183

Call 4024928300 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

11110 Fort St Ste 106

Omaha, NE 681642183

Telephone 4024928300
Organization at the Same NPPES Address or Phone
Missouri Valley Dental Group, Llc Facility NPI 1437467628

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2025

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Omaha and Nebraska

233 active clinicians are listed under Dentist with a practice address in Omaha, NE (662 in Nebraska).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Omaha

0% of these 233 clinicians have the CMS telehealth indicator.

0.4% of these 233 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-07-30
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES NE 8115

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Nebraska State Medical Licensing Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

5 listed
NPI 1265925853

Doctor of Dental Surgery

Dr. Jacob Copenhaver , DDS

Dentist - General Practice

NPI 1750063970

Doctor of Dental Surgery

Dr. Brad Erickson , DDS

Dentist - General Practice

NPI 1326779430

Doctor of Dental Surgery

Dr. Kyle Wiblishouser , DDS

Dentist - General Practice

NPI 1386262954

Doctor of Dental Surgery

NPI 1407237407

Doctor of Dental Surgery

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

7 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2025

Dentist (license number reported to NPPES: NE 8115)

βœ…
NPI Profile Active April 25, 2025

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 25, 2025

Registered at 11110 FORT ST STE 106, OMAHA, NE 681642183 (Tel: 4024928300)

πŸ“
Business Mailing Address (Initial Record) April 25, 2025

Registered at 406 MAYMONT DR, CRAMERTON, NC 280321611 (Tel: 7048406342)

πŸ‘€
Provider Name / Credentials (Initial Record) April 25, 2025

Recorded as JONATHAN RUSSO, DDS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 25, 2025

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 25, 2025

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1780472308
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 25, 2025
Last Update: July 30, 2025
Sole Proprietor: Yes

Other Dentists in Omaha

All Dentists in Omaha

Mailing Address

406 Maymont Dr

Cramerton, NC 280321611

Phone: 7048406342

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.