Active NPI
Kimberly Jean Fulton, D.M.D.
- Dentist
- Surprise, AZ
National Provider Identifier
1528092863
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D5424
- Practice address
- 15033 W Bell Rd
Suite 100
Surprise, AZ 85374-3217 - Phone
- (623) 537-9100
- Fax
- (623) 518-3168
- NPI assigned
- Jul 11, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | D5424 | AZ | Primary |
Addresses
Primary practice location
15033 W Bell Rd
Suite 100
Surprise, AZ 85374-3217
Mailing address
15033 W Bell Rd
Suite 100
Surprise, AZ 85374-3217
Phone (623) 537-9100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5424 | AZ | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Desert Dentistry, PLLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- Surprise, AZ
- NPI 1023332418
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152576000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1528092863",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15033 W BELL RD",
"address_2": "SUITE 100",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743217",
"telephone_number": "623-537-9100",
"fax_number": "623-518-3168"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15033 W BELL RD",
"address_2": "SUITE 100",
"city": "SURPRISE",
"state": "AZ",
"postal_code": "853743217",
"telephone_number": "623-537-9100",
"fax_number": "623-518-3168"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULTON",
"first_name": "KIMBERLY",
"middle_name": "JEAN",
"name_prefix": "Dr.",
"credential": "D.M.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "AZ",
"license": "D5424",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Surprise, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.