NPIMap

Individual provider Active NPI

Gregory Paul Fuller, DDS

  • Dentist
  • Milford, MA
National Provider Identifier
1023176591
Registry record updated May 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1859342 Issued in MA
Practice address
128 Medway Rd Ste 2&3
Milford, MA 01757-2915
Phone
(781) 325-1091
NPI assigned
Dec 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 5, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D2547 AZ
General Practice Dentistry 1223G0001X D2547 AZ
Dentist 122300000X DN1859342 MA Primary

Addresses

Primary practice location

128 Medway Rd Ste 2&3
Milford, MA 01757-2915

Mailing address

9885 E Cinnabar Ave
Scottsdale, AZ 85258-4737
Phone (520) 907-0719

Other practice location 1

11015 N Scottsdale Rd Ste 101
Scottsdale, AZ 85254-5196
Phone (480) 544-2800

Other names 1

  • Dr. Gregory P Fuller Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D2547AZMDDentist
DN1859342MAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dirk a Newman DDS, PC Dentist Past Accepting new patients
Scottsdale and Shea Dental Group, LLP Dentist Past Accepting new patients
Milford Dentist Office, PC Dentist PastSince May 8, 2022 Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1023176591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9885 E CINNABAR AVE",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852584737",
            "telephone_number": "520-907-0719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "128 MEDWAY RD STE 2&3",
            "city": "MILFORD",
            "state": "MA",
            "postal_code": "017572915",
            "telephone_number": "781-325-1091"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11015 N Scottsdale Rd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852545196",
            "country_code": "US",
            "telephone_number": "480-544-2800",
            "fax_number": "480-544-1148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "GREGORY",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-05",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "D2547",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D2547",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1859342",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GREGORY",
            "last_name": "FULLER",
            "middle_name": "P",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Milford, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.