Rawley H. Fuller, IV, DDS, PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6491 Issued in NC

Legal business name

RAWLEY H. FULLER, IV, DDS, PA

Practice address

3450 Forestdale Dr.
Burlington, NC 27215-9142

Phone

(336) 226-0855

Fax

(336) 226-0137

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Rawley Harrison Fuller IV, DDS, PA

Title

Dentist & Owner

Phone

(336) 226-0855

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1418947200000",
    "number": "1609949155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3450 FORESTDALE DR.",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159142",
            "telephone_number": "336-226-0855",
            "fax_number": "336-226-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 FORESTDALE DR.",
            "city": "BURLINGTON",
            "state": "NC",
            "postal_code": "272159142",
            "telephone_number": "336-226-0855",
            "fax_number": "336-226-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAWLEY H. FULLER, IV, DDS, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2014-12-19",
        "status": "A",
        "authorized_official_last_name": "FULLER",
        "authorized_official_first_name": "RAWLEY",
        "authorized_official_middle_name": "HARRISON",
        "authorized_official_title_or_position": "DENTIST & OWNER",
        "authorized_official_telephone_number": "336-226-0855",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "IV",
        "authorized_official_credential": "DDS, PA"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6491",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8992953",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jenece Ranger
• Archana C Rao, MD
• Elizabeth Moore Rasmussen, PA-C
• Heather R Ratcliffe, PA-C
• Jayashree Ravishankar, M.D.
• Lawanda Ray, RN
• Mark Joseph Rebeck, OD
• Rebekah Finger, D.M.D., PA
• Reclaim Counseling and Wellness
• Pallavi Dundumalla Reddy, M.D.

• General Practice Dentistry in Burlington, NC
• Providers in Burlington, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2014; 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.