Dr. Joseph W. Fuller

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN008166 Issued in FL

Legal business name

DR. JOSEPH W. FULLER

Practice address

1204 N Center St
Perry, FL 32347-2038

Phone

(850) 584-4613

Fax

(850) 584-9009

NPI assigned

Feb 19, 2007

Last updated

Sep 6, 2023By 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. Joseph Warren Fuller III, D.D.S.

Title

Dentist

Phone

(850) 584-4613

Specialties & licenses 1

Addresses

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.

• Joesph Warren Fuller III, D.D.S.

  • General Practice Dentistry
  • Perry, FL
  • NPI 1548344757
  NPD (past)

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

{
    "created_epoch": "1171843200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1693958400000",
    "number": "1407990609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1204 N CENTER ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472038",
            "telephone_number": "850-584-4613",
            "fax_number": "850-584-9009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1204 N CENTER ST",
            "city": "PERRY",
            "state": "FL",
            "postal_code": "323472038",
            "telephone_number": "850-584-4613",
            "fax_number": "850-584-9009"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JOSEPH W. FULLER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-19",
        "last_updated": "2023-09-06",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "WARREN",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "850-584-4613",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN008166",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Diane Dodgen, M.D.
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• Jia Li Duan, DO
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• Laura L Early, RN

• General Practice Dentistry in Perry, FL
• Providers in Perry, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; 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.