Anna T. Fuller, DMD, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANNA T. FULLER, DMD, LLC

Practice address

145 Pelham Dr
Columbia, SC 29209-1321

Phone

(803) 602-3862

NPI assigned

Nov 1, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Anna T Fuller, DMD

Title

Member

Phone

(803) 528-8351

Specialties & licenses 1

Addresses

Other names 1

• Friendly Dental of Columbia Doing business as

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

{
    "created_epoch": "1477958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1376095885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 PELHAM DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091321",
            "telephone_number": "803-602-3862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PELHAM DR",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292091321",
            "telephone_number": "803-602-3862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANNA T. FULLER, DMD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-01",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "ANNA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "803-528-8351",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Friendly Dental of Columbia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Columbia, SC
• Providers in Columbia, SC by specialty
• General Practice Dentistry in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.