Individual provider Active NPI

Ryan Michael Fulchi, DMD

  • Dentist
  • Savannah, GA
National Provider Identifier
1639490675
Registry record updated Jun 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN014084 Issued in GA
Practice address
2515 Habersham St
Savannah, GA 31401-9346
Phone
(912) 234-2206
Fax
(912) 238-1522
NPI assigned
Jun 14, 2010
Last updated
Jun 14, 2010By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 14, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN014084 GA Primary

Addresses

Primary practice location

2515 Habersham St
Savannah, GA 31401-9346

Mailing address

430 Peachtree Dr
Rincon, GA 31326-4889
Phone (706) 461-6781

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001989 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 0547572158

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Islands Family Dental, LLC Dentist Current Accepting new patients
310Habershamdental LLC Dentist Current Accepting new patients
Habersham Dental of Savannah LLC Current Accepting new patients
Habersham Dental Partners, LLC Past Accepting new patients

Locations

2515 Habersham St
Savannah, GA 31401
Phone (912) 234-2206

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1276473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276473600000",
    "number": "1639490675",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "430 PEACHTREE DR",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313264889",
            "telephone_number": "706-461-6781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 HABERSHAM ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314019346",
            "telephone_number": "912-234-2206",
            "fax_number": "912-238-1522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULCHI",
        "first_name": "RYAN",
        "middle_name": "MICHAEL",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-06-14",
        "last_updated": "2010-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN014084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.