Organization Active NPI

Fuller & Associates 13, PLLC

Doing business as Southern Pines Family & Cosmetic Dentistry

  • General Practice Dentistry
  • Southern Pines, NC
National Provider Identifier
1306732763
Registry record updated Jun 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
Legal business name
FULLER & ASSOCIATES 13, PLLC
Doing business as
Southern Pines Family & Cosmetic Dentistry
Practice address
655 SW Broad St
Southern Pines, NC 28387-5925
Phone
(910) 692-6500
NPI assigned
Jun 13, 2025
Last updated
Jun 13, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2025

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

Authorized official

Name
Chad Rumley
Title
Coo
Phone
(336) 586-5012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X Primary

Addresses

Primary practice location

655 SW Broad St
Southern Pines, NC 28387-5925

Mailing address

3450 Forestdale Dr
Burlington, NC 27215-9142
Phone (336) 586-5012

Other names 1

  • Southern Pines Family & Cosmetic Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

655 SW Broad St
Southern Pnes, NC 28387
Phone (910) 692-6500

NPI Registry JSON

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

{
    "created_epoch": "1749772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749772800000",
    "number": "1306732763",
    "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": "655 SW BROAD ST",
            "city": "SOUTHERN PINES",
            "state": "NC",
            "postal_code": "283875925",
            "telephone_number": "910-692-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLER & ASSOCIATES 13, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-13",
        "last_updated": "2025-06-13",
        "certification_date": "2025-06-13",
        "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"
    },
    "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": "Southern Pines Family & Cosmetic Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southern Pines, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 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.