NPIMap

Organization Active NPI

Fullenkamp Family Dentistry

  • General Practice Physician
  • Franklin, OH
National Provider Identifier
1518630359
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
FULLENKAMP FAMILY DENTISTRY
Doing business as
Fullenkamp Family Dentistry
Practice address
1051 Commerce Center Dr
Franklin, OH 45005-7209
Phone
(937) 746-3901
Fax
(937) 746-4183
NPI assigned
Jul 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Leryn Bourquin
Title
Manager
Phone
(937) 746-3907

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208D00000X Primary

Addresses

Primary practice location

1051 Commerce Center Dr
Franklin, OH 45005-7209

Mailing address

1051 Commerce Center Dr
Franklin, OH 45005-7209
Phone (937) 746-3901

Other names 1

  • Fullenkamp Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Locations

1051 Commerce Center Dr
Franklin, OH 45005
Phone (937) 746-3901

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1627430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1518630359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1051 COMMERCE CENTER DR",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450057209",
            "telephone_number": "937-746-3901",
            "fax_number": "937-746-4183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 COMMERCE CENTER DR",
            "city": "FRANKLIN",
            "state": "OH",
            "postal_code": "450057209",
            "telephone_number": "937-746-3901",
            "fax_number": "937-746-4183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLENKAMP FAMILY DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-28",
        "last_updated": "2021-07-28",
        "certification_date": "2021-07-23",
        "status": "A",
        "authorized_official_last_name": "BOURQUIN",
        "authorized_official_first_name": "LERYN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "937-746-3907"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fullenkamp Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Franklin, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.