Robert C Fuller DDS & Jennifer R Fuller DDS

Primary specialty

DentistTaxonomy code 122300000X

License

17660 Issued in MI

Legal business name

ROBERT C FULLER DDS & JENNIFER R FULLER DDS

Practice address

334 Livernois
Ferndale, MI 48220

Phone

(313) 864-9110

Fax

(313) 864-8750

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jennifer R Fuller, DDSNPI 1831364108

Title

Dentist/Owner

Phone

(313) 864-9110

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jennifer Renee Fuller, DDS

  • Dentist
  • Ferndale, MI
  • NPI 1831364108
  NPD Authorized official

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1676505600000",
    "number": "1124242912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 LIVERNOIS",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "48220",
            "telephone_number": "313-864-9110",
            "fax_number": "313-864-8750"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 LIVERNOIS",
            "city": "FERNDALE",
            "state": "MI",
            "postal_code": "48220",
            "telephone_number": "313-864-9110",
            "fax_number": "313-864-8750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT C FULLER DDS & JENNIFER R FULLER DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2023-02-16",
        "certification_date": "2023-02-16",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST/OWNER",
        "authorized_official_telephone_number": "313-864-9110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "MI",
            "license": "17660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naheim Rida, LLMSW
• Kirsten Riley, LMSW-C, SSW
• Christian Ringold
• Eyonna Chanel Riser
• Rite Aid of Michigan Inc
• Mary Robert
• Lauren M Roberts
• Latrice Robinson, MA, LLP
• Shavon Robinson, LMSW
• Dale Rohrbach, LPC

• Dentist in Ferndale, MI
• Providers in Ferndale, MI by specialty
• Dentist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2023; 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.