Michael Terry Fulbright, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

47892 Issued in CA

Practice address

1815 Via El Prado
200
Redondo Beach, CA 90277-5722

Phone

(310) 316-4477

Fax

(310) 316-4475

NPI assigned

Feb 14, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Fulbright and Faist Dental Partnership

  • General Practice Dentistry
  • Redondo Beach, CA
  • NPI 1568247203
  NPD Authorized official
• Michael T. Fulbright DDS a Professional Corporation

  • Dentist
  • Redondo Beach, CA
  • NPI 1669869087
  NPD (past) Authorized official
• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  NPD

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

{
    "created_epoch": "1171411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434412800000",
    "number": "1962545764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 VIA EL PRADO",
            "address_2": "200",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775722",
            "telephone_number": "310-316-4477",
            "fax_number": "310-316-4475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 VIA EL PRADO",
            "address_2": "200",
            "city": "REDONDO BEACH",
            "state": "CA",
            "postal_code": "902775722",
            "telephone_number": "310-316-4477",
            "fax_number": "310-316-4475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULBRIGHT",
        "first_name": "MICHAEL",
        "middle_name": "TERRY",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-14",
        "last_updated": "2015-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "47892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Cristina Frisancho, OTR/L
• Andrew Frisina
• Rio Marie Frohoff
• Dionne Fugate
• Fulbright and Faist Dental Partnership
• Dean A Furkioti, DDS
• Dean Arthur Angelo Furkioti Jr., DDS
• G Smith MD Medical Group Inc.
• Lulit Gabre, IBCLC
• Gabriel Lanum Licensed Marriage & Family Therapy Inc

• General Practice Dentistry in Redondo Beach, CA
• Providers in Redondo Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.