Shane Alan Fuller, D.D.S.

Dentist · Spring Valley, CA

Individual Active NPI

NPI number 1326450867

Practice location

8788 Jamacha Rd
Spring Valley, CA 91977-4035
Phone
(619) 515-2555

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NPI record

NPI
1326450867
Entity type
Individual (Type 1)
Enumeration date
June 2, 2014
Last updated
March 17, 2018
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 63426 CA

Mailing address

71600 Gardess Rd
Rancho Mirage, CA 92270-4225

Other practice locations (1)

  • 245 N 15th St, Ms467, Philadelphia, PA 19102-1101 · (215) 762-5643

About Dr. Fuller

Shane Alan Fuller, D.D.S. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 8788 Jamacha Rd, Spring Valley, CA 91977-4035. The NPI number 1326450867 was assigned on June 2, 2014 and the record was last updated on March 17, 2018.

Dr. Fuller lists a license in the registry: #63426 (CA) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Shane Alan Fuller, D.D.S.?

The NPI number is 1326450867.

What is the phone number of Dr. Fuller?

The phone number listed for the practice location is (619) 515-2555.

Where is Dr. Fuller located?

8788 Jamacha Rd, Spring Valley, CA 91977-4035.

What is the taxonomy code for Dr. Fuller?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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