Hayden Fuller, DDS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

81 Issued in OK

Practice address

4320 McAuley Blvd
Oklahoma City, OK 73120-8386

Phone

(405) 755-4826

NPI assigned

Jul 2, 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

Electronic endpoints 1

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": "1530489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612828800000",
    "number": "1881180974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2141 HUNTLEIGH DR",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731203806",
            "telephone_number": "405-414-7481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 MCAULEY BLVD",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731208386",
            "telephone_number": "405-755-4826"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 N Stonewall Ave # Dcsb253",
            "address_purpose": "LOCATION",
            "city": "Oklahoma City",
            "state": "OK",
            "postal_code": "731171214",
            "country_code": "US",
            "telephone_number": "405-414-7481",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULLER",
        "first_name": "HAYDEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-02",
        "last_updated": "2021-02-09",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OK",
            "license": "6853",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Periodontics",
            "state": "OK",
            "license": "81",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "info@oklahomacityoralsurgery.com",
            "affiliation": "N",
            "endpointDescription": "secure work email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "secure work email",
            "address_1": "4320 McAuley Blvd",
            "city": "Oklahoma City",
            "state": "OK",
            "country_code": "US",
            "postal_code": "731208386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bennett E Fuller, M.D.
• Cameron Fuller
• David Fuller
• Esther Marie Fuller, M.S.C.P.
• Falon D Fuller, MD
• John Alan Fuller, M.D.
• Kaleb Evan Fuller, DO
• Katheryn Fuller, PHD, RD/LD
• Marni Fuller, DDS
• Raechyl Fuller

• Periodontics in Oklahoma City, OK
• Providers in Oklahoma City, OK by specialty
• Periodontics in Oklahoma

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