DR. JOSEPH FULLMER (NPI# 1487887204) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487887204 |
| Entity Type | Individual |
| Full Name | DR. JOSEPH FULLMER |
| Credential | DMD |
| Practice Address |
493 S Main St # 200 Heber City UT 84032-2240 |
| Practice Telephone | 4353152050 |
| Mailing Telephone | 4353152050 |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2020-05-15 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
7076335-9924 | UT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | 1043627607 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902984438 | Joseph Fullmer | Pathology | 3601 W 13 Mile Rd, Royal Oak, MI 48073 | 2006-11-01 |
| Street Address |
493 S MAIN ST # 200 |
| City | HEBER CITY |
| State | UT |
| Zip Code | 84032-2240 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134733439 | Kelly C Cook | Student in an Organized Health Care Education/Training Program | 55 500 E, Heber, UT 84032 | 2020-09-03 |
| 1558807883 | Heber City Dental | Dentist | 345 E Gateway Drive, Suite 200, Heber City, UT 84032 | 2017-01-10 |
| 1326584921 | Deer Creek Childrens Dentistry | Dentist | 575 South 200 East, Heber City, UT 84032 | 2017-01-06 |
| 1194197871 | Ryan Hall | Physician Assistant | 150 N Main St #105, Heber City, UT 84032 | 2015-10-21 |
| 1841686631 | Jamar Romanceles Grayson | Family Medicine | 1485 Us-40 Ste G, Heber City, Ut 84032, Heber City, UT 84032 | 2015-04-08 |
| 1003218512 | Zebadia Pessetto | Physical Therapist | 380 E 1500 S Ste 102, Heber City, UT 84032 | 2014-09-16 |
| 1033471602 | Erik Mcclure | Anesthesiology | 899 E 200 S, Heber City, UT 84032 | 2012-06-11 |
| 1164716122 | Alicia M Power | Marriage & Family Therapist | 55 South 500 North, Heber City, UT 84032 | 2011-06-07 |
| 1073849873 | Ron T Dummar | Chiropractor | 325 West 600 S St. 403, Heber, UT 84032 | 2009-10-29 |
| 1407031255 | Wasatch County Health Department | Public Health or Welfare | 55 East 500 South, Heber City, UT 84032 | 2007-12-28 |
| Find all providers in zip 84032 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528286226 | Jerold R. Sorensen | Dentist | 90 W 500 S, Heber City, UT 84032 | 2007-04-20 |
| 1770701476 | Jerold R Sorensen Dds A Professional Corporation | Dentist | 90 W 500 S, Heber City, UT 84032 | 2007-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891394631 | Vineyard Oral and Maxillofacial Surgery | Dentist | 707 E Mill Rd Ste 102, Vineyard, UT 84059-5732 | 2020-10-22 |
| 1306489059 | Alpine Dentists and Specialists Pllc | Dentist | 20 W Main Street Ct Ste 100, Alpine, UT 84004-1889 | 2019-10-25 |
| 1194213074 | Lehi Oral Surgery PC | Dentist | 2961 W Maple Loop Dr Ste 130, Lehi, UT 84043-5717 | 2018-04-26 |
| 1568974434 | Utah Wisdom Teeth, LLC | Dentist | 1030 E 11400 S Ste 2a, Sandy, UT 84094-6906 | 2017-10-31 |
| 1447623830 | Great Smiles Dental Clinic LLC | Dentist | 7410 S Creek Rd, #303, Sandy, UT 84093-6140 | 2015-11-06 |
| 1679943831 | Creekside Oral & Facial Surgery Inc | Dentist | 7390 S Creek Rd, Suite 101, Sandy, UT 84093-6119 | 2015-09-30 |
| 1346629441 | Eric Wood | Dentist | 3610 N University Ave Ste 150, Provo, UT 84604-4444 | 2015-05-21 |
| 1023336104 | Adam C Stanley | Dentist | 3632 W South Jordan Pkwy Ste 103, South Jordan, UT 84009-7163 | 2010-05-13 |
| 1790012243 | Southern Utah Surgical Arts | Dentist | 393 E Riverside Dr Bldg 2, Suite 2b, St George, UT 84790-7065 | 2009-11-04 |
| 1407085160 | Davis Center for Oral & Maxillofacial Surgery | Dentist | 890 Heritage Park Blvd Ste 103, Layton, UT 84041-5622 | 2009-07-02 |
| Find all providers with the same taxonomy | ||||
| City | HEBER CITY |
| Zip Code | 84032 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.