Adelle Fuller, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DEN.00205678 Issued in CO

Practice address

5198 N Nevada Ave Ste 100
Colorado Springs, CO 80918-8649

Phone

(719) 634-8884

NPI assigned

Jun 28, 2023

Last updated

Jun 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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.

• The Springs Modern Dentistry, LLP

  dba The Springs Modern Dentistry

  • General Practice Dentistry
  • Colorado Springs, CO
  • NPI 1700116589

  Multi-Specialty

  NPD (past)

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

{
    "created_epoch": "1687910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1154008472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5198 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5198 N NEVADA AVE STE 100",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809188649",
            "telephone_number": "719-634-8884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ADELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-28",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "DEN.00205678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Evan Gregg Fukuhara
• Fulcrum Counseling, Inc.
• Full Circle Family Home Health, LLC.
• Full Circle Family Ihss, LLC (Full Circle Family Home Health, LLC)
• Full Spectrum Home Care Services
• Amanda Shea Fuller, MA, LPC
• Ashley Kae Fuller, PT, DPT
• Elise J. Fuller, PHD
• Jessica Fuller
• Kimberly Fuller

• Dentist in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.