Tayler Danyelle Fuller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7461 Issued in NE

Practice address

2602 J St
Omaha, NE 68107-1643

Phone

(402) 733-1325

NPI assigned

Jun 1, 2018

Sex

Female

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

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

{
    "created_epoch": "1527811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554768000000",
    "number": "1669964003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2537 S 3RD STREET PLZ",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681081709",
            "telephone_number": "208-553-6977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2602 J ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681071643",
            "telephone_number": "402-733-1325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11110 Fort St Ste 106",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681642183",
            "country_code": "US",
            "telephone_number": "402-492-8300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1509 Avenue G",
            "address_purpose": "LOCATION",
            "city": "Council Bluffs",
            "state": "IA",
            "postal_code": "515012516",
            "country_code": "US",
            "telephone_number": "712-325-1544",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "214 E Erie St",
            "address_purpose": "LOCATION",
            "city": "Missouri Valley",
            "state": "IA",
            "postal_code": "51555",
            "country_code": "US",
            "telephone_number": "712-642-3491",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "TAYLER",
        "middle_name": "DANYELLE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-01",
        "last_updated": "2019-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-09543",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7461",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• George Fuller
• Jessica Fuller, LIMHP, NCC, LPC
• Jonathan Ellis Fuller, M.D.
• Redgy Fuller, DO
• Shayona Fuller
• Tyreshia Fuller
• Nathan Fullinfaw
• Fulton Homes Assisted Living
• Amanda M Fulton
• Brianna Fulton

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 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.