Shawn Fuller, D.D.S

Primary specialty

DentistTaxonomy code 122300000X

License

DN1857804 Issued in MA

Practice address

193 Boston Tpke Ste 6140
Shrewsbury, MA 01545

Phone

(508) 669-7140

Fax

(508) 669-7140

NPI assigned

Feb 4, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Shrewsbury Dentistry, PC

  • General Practice Dentistry
  • Shrewsbury, MA
  • NPI 1417452772
  NPD (past)
• Scottsdale Modern Dentistry and Orthodontics, LLP

  • General Practice Dentistry
  • Scottsdale, AZ
  • NPI 1730434515
  NPD (past)

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573603200000",
    "number": "1639401334",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "193 BOSTON TPKE STE 6140",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "015452552",
            "telephone_number": "508-669-7140",
            "fax_number": "508-669-7140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "193 BOSTON TPKE STE 6140",
            "city": "SHREWSBURY",
            "state": "MA",
            "postal_code": "01545",
            "telephone_number": "508-669-7140",
            "fax_number": "508-669-7140"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "228 Washington St Ste 140",
            "address_purpose": "LOCATION",
            "city": "Attleboro",
            "state": "MA",
            "postal_code": "027035563",
            "country_code": "US",
            "telephone_number": "480-363-6444",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10260 N 90th St",
            "address_purpose": "LOCATION",
            "city": "Scottsdale",
            "state": "AZ",
            "postal_code": "852584408",
            "country_code": "US",
            "telephone_number": "480-941-3907",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4510 S Eastern Ave",
            "address_2": "Suite 2",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891196149",
            "country_code": "US",
            "telephone_number": "702-734-7839",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SHAWN",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-02-04",
        "last_updated": "2019-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1857804",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "7840",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Anne Franger, DPM
• Robert R Franger, DPM
• Emma Beth Freedlander, CCC-SLP
• Ashley Elizabeth Fuller, DNP-C
• Ingrid Fuller, M.D.
• Robert Anthony Fusco, LMT, MMP
• Patricia Gagnon
• John T Gallagher, M.D.
• Heather L Gallo, M.D.
• Anjanaben M Gami

• Dentist in Shrewsbury, MA
• Providers in Shrewsbury, MA by specialty
• Dentist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2019; 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.