Anna T. Fuller, DMD, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ANNA T. FULLER, DMD, LLC

Doing business as

Friendly Dental of Columbia

Practice address

145 Pelham Dr
Columbia, SC 29209-1321

Phone

(803) 602-3862

NPI assigned

Nov 1, 2016

Last updated

Nov 1, 2016By the provider in NPPES

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, DMDNPI 1417152190

Title

Member

Phone

(803) 528-8351

Specialties & licenses 1

Addresses

Other names 1

• Friendly Dental of Columbia Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Anna Tyson Fuller, D.M.D.

  • General Practice Dentistry
  • Columbia, SC
  • NPI 1417152190
  Authorized official Same address or phone

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.