Fuller & Associates 14, PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

FULLER & ASSOCIATES 14, PLLC

Doing business as

Irving Park Family & Cosmetic Dentistry

Practice address

1515 W Cornwallis Dr Ste 120
Greensboro, NC 27408-6334

Phone

(336) 379-1207

NPI assigned

Jun 16, 2025

Organization subpart

No

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

Authorized official

Name

Mr. Chad Rumley

Title

Coo

Phone

(336) 586-5012

Specialties & licenses 1

Addresses

Other names 1

• Irving Park Family & Cosmetic Dentistry Doing business as

Locations

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

{
    "created_epoch": "1750032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1750032000000",
    "number": "1083500953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 FORESTDALE DR",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159142",
            "telephone_number": "336-586-5012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W CORNWALLIS DR STE 120",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274086334",
            "telephone_number": "336-379-1207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER & ASSOCIATES 14, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-16",
        "last_updated": "2025-06-16",
        "certification_date": "2025-06-16",
        "status": "A",
        "authorized_official_last_name": "RUMLEY",
        "authorized_official_first_name": "CHAD",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "336-586-5012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Irving Park Family & Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• FS I Services, PLLC
• Bryan H Fujimoto, LCSWA
• Kim Mika Fujinaga, M.D.
• Bethany Smith Fulk
• Kimberly Beaman Fulkerson, MED,CCC-SLP
• David Lee Fuller, M.D.
• Sandra Fuller, DDS
• Scott Lee Fuller
• Austin Fullmer
• Christina Fullwood, BSN, RN

• General Practice Dentistry in Greensboro, NC
• Providers in Greensboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2025; 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.