Sandra Fuller, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

6821 Issued in NC

Practice address

1515 W Cornwallis Dr
Greensboro, NC 27408-6338

Phone

(336) 379-1206

Fax

(336) 379-1733

NPI assigned

Aug 15, 2006

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Sandra L. Fuller,DDS,P.a.

  • General Practice Dentistry
  • Greensboro, NC
  • NPI 1326051707
  NPD (past) Authorized official

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

{
    "created_epoch": "1155600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982617361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 W CORNWALLIS DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274086338",
            "telephone_number": "336-379-1206",
            "fax_number": "336-379-1733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 W CORNWALLIS DR",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274086338",
            "telephone_number": "336-379-1206",
            "fax_number": "336-379-1733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "SANDRA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "6821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim Mika Fujinaga, M.D.
• Bethany Smith Fulk
• Kimberly Beaman Fulkerson, MED,CCC-SLP
• Fuller & Associates 14, PLLC (Irving Park Family & Cosmetic Dentistry)
• David Lee Fuller, M.D.
• Scott Lee Fuller
• Austin Fullmer
• Christina Fullwood, BSN, RN
• Feletia Fullwood
• Taleitha Fullwood

• General Practice Dentistry in Greensboro, NC
• Providers in Greensboro, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.