Active NPI
Anna G Fuller, DMD
- Dentist
- Ogden, UT
National Provider Identifier
1982863585
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 8211338-9922
- Practice address
- 950 25TH St Ste a
Ogden, UT 84401-6823 - Phone
- (801) 395-7090
- NPI assigned
- Jun 9, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DD2990 | NM | |
| Dentist | 122300000X | 8211338-9922 | UT | Primary |
Addresses
Primary practice location
950 25TH St Ste a
Ogden, UT 84401-6823
Mailing address
1148 E Highway 193
Layton, UT 84040-8528
Phone (801) 771-4505
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| DD2990 | Other | NM | NM DENTAL LICENCE |
| 8211338-992 | Other | UT | UTAH DENTAL LICENCE - ANESTHESIA CLASS II PERMIT |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | annafuller@utah.gov | Direct |
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
| License | State | Type | Specialty |
|---|---|---|---|
| DD2990 | NM | MD | Dentist |
| 8211338-9922 | UT | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1212969600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1589328000000",
"number": "1982863585",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1148 E HIGHWAY 193",
"city": "LAYTON",
"state": "UT",
"postal_code": "840408528",
"telephone_number": "801-771-4505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "950 25TH ST STE A",
"city": "OGDEN",
"state": "UT",
"postal_code": "844016823",
"telephone_number": "801-395-7090"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FULLER",
"first_name": "ANNA",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-09",
"last_updated": "2020-05-13",
"certification_date": "2020-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD2990",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "8211338-9922",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NM DENTAL LICENCE",
"identifier": "DD2990",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UTAH DENTAL LICENCE - ANESTHESIA CLASS II PERMIT",
"identifier": "8211338-992",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "annafuller@utah.gov",
"affiliation": "N",
"endpointDescription": "state of utah email address",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "email",
"address_1": "950 25th St Ste A",
"city": "Ogden",
"state": "UT",
"country_code": "US",
"postal_code": "844016823",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.