Alexander Fuller, D.M.D.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DS039955 Issued in PA

Practice address

509 York Rd
Jenkintown, PA 19046

Phone

(267) 589-9636

NPI assigned

Oct 9, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jenkintown Endodontics, LLC

  • Endodontics
  • Jenkintown, PA
  • NPI 1386118958
  NPD Authorized official

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

{
    "created_epoch": "1412812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547683200000",
    "number": "1508260274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "509 YORK RD",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190462102",
            "telephone_number": "267-589-9636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "509 YORK RD",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "19046",
            "telephone_number": "267-589-9636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Highpoint Dr Ste 220",
            "address_purpose": "LOCATION",
            "city": "Chalfont",
            "state": "PA",
            "postal_code": "18914",
            "country_code": "US",
            "telephone_number": "215-488-7855",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "509 York Rd",
            "address_purpose": "LOCATION",
            "city": "Jenkintown",
            "state": "PA",
            "postal_code": "19046",
            "country_code": "US",
            "telephone_number": "267-589-9636",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "ALEXANDER",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-10-09",
        "last_updated": "2019-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS039955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Martha Jane Fried-Cassorla, PHD
• Emily Froggatt, CRNP
• Rhoda Edwina Fuchs Morton, LPC
• Melinda T Fudge, M.D.
• Judith Fuhrman, LCSW
• Candace Funderburk
• Caroline Marie Hughes Furman, FNP
• Jaspreet Gadria
• Gregg Stephen Gagliardi, M.D.
• Ryan Gannon

• Endodontics in Jenkintown, PA
• Providers in Jenkintown, PA by specialty
• Endodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2019; 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.