Fullfill, Inc.

Primary specialty

Prevention ProfessionalTaxonomy code 405300000X

Legal business name

FULLFILL, INC.

Practice address

10866 Wilshire Blvd Ste 400
Los Angeles, CA 90024-4338

Phone

(833) 385-5345

NPI assigned

Nov 6, 2019

Organization subpart

No

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

Authorized official

Name

Peyman Dadmehr

Title

Clo

Phone

(833) 385-5345

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1572998400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1620345600000",
    "number": "1629612247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10866 WILSHIRE BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244338",
            "telephone_number": "833-385-5345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10866 WILSHIRE BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900244338",
            "telephone_number": "833-385-5345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLFILL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-06",
        "last_updated": "2021-05-07",
        "certification_date": "2021-05-07",
        "status": "A",
        "authorized_official_last_name": "DADMEHR",
        "authorized_official_first_name": "PEYMAN",
        "authorized_official_title_or_position": "CLO",
        "authorized_official_telephone_number": "833-385-5345"
    },
    "taxonomies": [
        {
            "code": "405300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Prevention Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• M. Camille Fuller, D.D.S.
• Myesha Fuller, CMT
• Perry Fuller
• Samantha Elizeth Fuller
• Solomon Fuller
• Howard J. Fullman, MD
• Mellisa Fulmer
• Tyequighae Fulton
• Fun Dental 4 Kids 2
• Fun Dental 4 Kids 4

• Prevention Professional in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Prevention Professional in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 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.