Kaleigh E Fulmer, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001623 Issued in WI

Practice address

2909 Roosevelt Rd
Kenosha, WI 53143-4641

Phone

(262) 671-4724

NPI assigned

Jun 22, 2017

Last updated

Mar 17, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Family & Restorative Dentistry

  dba Fulmer Dentistry

  • Dental Clinic/Center
  • Salem, WI
  • NPI 1497276729
  NPD (past)

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

{
    "created_epoch": "1498089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1093235871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4015 HARDING RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531427038",
            "telephone_number": "262-945-7722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2909 ROOSEVELT RD",
            "city": "KENOSHA",
            "state": "WI",
            "postal_code": "531434641",
            "telephone_number": "262-671-4724"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7137 236th Ave Ste 108",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "WI",
            "postal_code": "531688975",
            "country_code": "US",
            "telephone_number": "262-843-4643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULMER",
        "first_name": "KALEIGH",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-22",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001623",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• FS Outpatient Imaging Center LLC
• Fulfilling a Need,LLC
• Emily Ellen Fulk, PA-C
• Kevin J Fullin, MD FACC
• Patricia Fullin, ACUPUNCTURISTS
• Laura Fulmer, RN
• Dequan M Gaddis Jr., CPHT
• Jui Siddharth Gaikwad
• Lauren Galicia Magnuson, OT
• Vincent Galis

• Dentist in Kenosha, WI
• Providers in Kenosha, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.