Active NPI
Fuller & Associates 13, PLLC
Doing business as Southern Pines Family & Cosmetic Dentistry
- General Practice Dentistry
- Southern Pines, NC
National Provider Identifier
1306732763
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- 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, 2025
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 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
National Provider Directory
National Provider DirectoryLocations
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.