NPIMap

Organization Active NPI

Fulp Family Dentistry, LLC

  • General Practice Dentistry
  • Tifton, GA
National Provider Identifier
1669609830
Registry record updated Oct 18, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN013912 Issued in GA
Legal business name
FULP FAMILY DENTISTRY, LLC
Practice address
215 Magnolia Dr N
Tifton, GA 31794-4217
Phone
(229) 382-7996
Fax
(229) 386-4832
NPI assigned
Jun 16, 2009
Last updated
Oct 18, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2011

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

Authorized official

Name
Dr. Scott Robison Fulp, D.M.D.NPI 1356578520
Title
President
Phone
(229) 386-4832

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN013912 GA Primary

Addresses

Primary practice location

215 Magnolia Dr N
Tifton, GA 31794-4217

Mailing address

215 Magnolia Dr N
Tifton, GA 31794-4217
Phone (229) 382-7996

National Provider Directory

National Provider Directory

Locations

215 Magnolia Dr N
Tifton, GA 31794
Phone (229) 382-7996

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318896000000",
    "number": "1669609830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 MAGNOLIA DR N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944217",
            "telephone_number": "229-382-7996",
            "fax_number": "229-386-4832"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 MAGNOLIA DR N",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944217",
            "telephone_number": "229-382-7996",
            "fax_number": "229-386-4832"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULP FAMILY DENTISTRY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-16",
        "last_updated": "2011-10-18",
        "status": "A",
        "authorized_official_last_name": "FULP",
        "authorized_official_first_name": "SCOTT",
        "authorized_official_middle_name": "ROBISON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-386-4832",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2011; 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.