DR. FREDERICK DALE FULLMER (NPI# 1497815104) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497815104 |
| Entity Type | Individual |
| Full Name | DR. FREDERICK DALE FULLMER |
| Credential | DDS |
| Practice Address |
888 Oak Grove Avenue Suite 11 Menlo Park CA 94025-4432 |
| Practice Telephone | 6503228442 |
| Practice Fax Number | 6503221242 |
| Mailing Telephone | 6503228442 |
| Mailing Fax Number | 6503221242 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 14290 | CA | Dental Providers |
| Street Address |
888 OAK GROVE AVENUE SUITE 11 |
| City | MENLO PARK |
| State | CA |
| Zip Code | 94025-4432 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396350112 | Grail, Inc. | Clinical Medical Laboratory | 1525 O'brien Drive, Menlo Park, CA 94025 | 2020-09-09 |
| 1528673399 | Hanan Wasse | Occupational Therapist | 860 Fremont # Apt 2, Menlo Park, CA 94025 | 2020-09-09 |
| 1356967608 | Raymond Joseph Brinkmann | Counselor | 795 Willow Road Bldg 332, Menlo Park, CA 94025 | 2020-06-23 |
| 1245859883 | Connie Margarita Alonzo-frisz | Marriage & Family Therapist | Garfield Community School, 3600 Middlefield Rd, Menlo Park, CA 94025 | 2020-04-14 |
| 1225661911 | Crossover Health Medical Group | Specialist | 193 Jefferson Dr., Menlo Park, CA 94025 | 2020-02-20 |
| 1942774732 | Irazema Garcia | Health Educator | 3000 Sand Hill Road, Building 3, Suite 240, Menlo Park, CA 94025 | 2019-01-15 |
| 1538639174 | Care Indeed, Inc. | Home Health | 890 Santa Cruz Ave., Menlo Park, CA 94025 | 2018-11-27 |
| 1639644370 | Wendy Figone | Massage Therapist | 575 Gilbert Ave., Menlo Park, CA 94025 | 2018-10-09 |
| 1437667540 | Christina E Kang | Nutritionist | 3639 Haven Ave Unit A424, Menlo Park, CA 94025 | 2018-01-11 |
| 1225492820 | Speachy Learning Center | Speech-Language Pathologist | 1164 Chestnut Street, Menlo Park, CA 94025 | 2016-04-09 |
| Find all providers in zip 94025 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205284312 | Veronica G Gonzalez | Dentist | 20 Willow Rd, #32, Menlo Park, CA 94025-3663 | 2016-05-31 |
| 1922477439 | Kim Morita | Dentist | 425 Burgess Drive, Menlo Park, CA 94025-2643 | 2015-09-15 |
| 1033518212 | Richard Sellen | Dentist | 150 Middlefield Rd, Ste 101, Menlo Park, CA 94025-3505 | 2014-08-14 |
| 1871835447 | Marisa Walker | Dentist | 150 Middlefield Road, Suite 101, Menlo Park, CA 94025 | 2013-03-21 |
| 1184960643 | Linda Lee | Dentist | 1000 Continental Dr, Menlo Park, CA 94025-6652 | 2013-01-02 |
| 1467693283 | Safa Hormat Maiwand | Dentist | 2043 Sterling Ave, Menlo Park, CA 94025-6015 | 2009-03-09 |
| 1568608149 | Sun Hae Choi | Dentist | 565 Willow Rd Apt 2, Menlo Park, CA 94025-2602 | 2009-01-02 |
| 1982816146 | Scott A. Hoffman, Dds Inc | Dentist | 825 Oak Grove Ave., Suite # 301, Menlo Park, CA 94025 | 2007-05-03 |
| 1952498206 | Scott A Hoffman | Dentist | 825 Oak Grove Ave, Suite 301, Menlo Park, CA 94025 | 2006-10-06 |
| 1962506006 | Anandhi Djegaradjane | Dentist | 910 Willow Road, Menlo Park, CA 94025 | 2006-09-11 |
| Find all providers in MENLO PARK | ||||
| City | MENLO PARK |
| Zip Code | 94025 |
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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.