Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Samuel Yohannes Russom, DDS

Individual provider Pediatric Dentistry · NPI 1144719196

Dr. Samuel Yohannes Russom, DDS is a Pediatric Dentistry in Chula Vista, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2018
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

2015 Birch Rd Ste 103
Chula Vista, CA 91915-2003
Phone: (619) 391-9287
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatric Dentistry (primary) Taxonomy 1223P0221X · Licence DDS104651 (CA)

Record details

NPI number1144719196
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedMay 4, 2018
Last updated in NPPESDecember 28, 2021
Certification dateDecember 28, 2021

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