Jessica Kay Fuller, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DDS-08981 Issued in IA

Practice address

2727 1St Ave SE
Cedar Rapids, IA 52402-4844

Phone

(319) 363-3575

NPI assigned

Aug 6, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jessica Kay Boehrs Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1249516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454544000000",
    "number": "1538390695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2727 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024844",
            "telephone_number": "319-363-3575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 1ST AVE SE",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524024844",
            "telephone_number": "319-363-3575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "JESSICA",
        "middle_name": "KAY",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-06",
        "last_updated": "2016-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "DDS-08981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "BOEHRS",
            "middle_name": "KAY",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Dentist in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.