Individual provider Active NPI

Deborah Fulks, RDH

  • Dental Hygienist
  • Athens, OH
National Provider Identifier
1891199014
Registry record updated Oct 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
31003566 Issued in OH
Practice address
278 W Union St
Athens, OH 45701-2310
Phone
(740) 592-4431
Fax
(740) 594-2370
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 17, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 31003566 OH Primary

Addresses

Primary practice location

278 W Union St
Athens, OH 45701-2310

Mailing address

278 W Union St
Athens, OH 45701-2310
Phone (740) 592-4431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
31003566OHMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413504000000",
    "number": "1891199014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "278 W UNION ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012310",
            "telephone_number": "740-592-4431",
            "fax_number": "740-594-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "278 W UNION ST",
            "city": "ATHENS",
            "state": "OH",
            "postal_code": "457012310",
            "telephone_number": "740-592-4431",
            "fax_number": "740-594-2370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULKS",
        "first_name": "DEBORAH",
        "credential": "RDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2014-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OH",
            "license": "31003566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2014; 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.