Mark Fulton, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12008901 Issued in IN

Practice address

3482 State Road 9 North
Anderson, IN 46012

Phone

(765) 642-1612

Fax

(765) 642-9227

NPI assigned

Jul 20, 2006

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765756800000",
    "number": "1992725998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3482 N STATE ROAD 9",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "460121240",
            "telephone_number": "765-621-3127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3482 STATE ROAD 9 NORTH",
            "city": "ANDERSON",
            "state": "IN",
            "postal_code": "46012",
            "telephone_number": "765-642-1612",
            "fax_number": "765-642-9227"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1121 W Michigan St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025211",
            "country_code": "US",
            "telephone_number": "317-274-7433",
            "fax_number": "317-274-2603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FULTON",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-12-15",
        "certification_date": "2025-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100172500",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jessica Friedlin, PA
• Phillip Stanley Frist, DDS
• Vanessa Frist, MA CCC SLP
• Ethan Thomas Frye
• Shelby Fugate, PA-C
• Shelby Furlin
• Amanda Jean Furr, M.D.
• Chloe Fuson, RBT
• Pamela Gaar
• Melinda Gail Gadberry, RPH

• General Practice Dentistry in Anderson, IN
• Providers in Anderson, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2025; 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.