FULTON FAMILY DENTAL, LTD. (NPI# 1578912713) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578912713 |
| Entity Type | Organization |
| Organization Name | FULTON FAMILY DENTAL, LTD. |
| Practice Address |
1308 Sunset Ave. Waukegan IL 60087 |
| Practice Telephone | 8472492621 |
| Practice Fax Number | 8472499043 |
| Mailing Telephone | 8472492621 |
| Enumeration Date | 2016-06-08 |
| Last Update Date | 2016-06-08 |
| Authorized Official Name | DR. DAVID JAMES FULTON JR. (PRESIDENT) |
| Authorized Official Telephone | 8472492621 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 060.002213 | IL | Dental Providers |
| Street Address |
1308 SUNSET AVE. |
| City | WAUKEGAN |
| State | IL |
| Zip Code | 60087 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982268017 | Michael Donavan Wilson | Counselor | 200 North Lewis, Waukegan, IL 60087 | 2019-04-24 |
| 1114412160 | David B Fuentes | Specialist/Technologist | 2904 Wall Ave, Waukegan, IL 60087 | 2018-06-22 |
| 1902852825 | American Drug Stores LLC | Durable Medical Equipment & Medical Supplies | 3124 N Lewis Ave, Waukegan, IL 60087 | 2006-05-25 |
| 1396723565 | Daram H Reddy Md | Psychiatry & Neurology | 609 Greenwood Ave, Waukegan, IL 60087 | 2006-01-06 |
| 1609200328 | Rosa Margaret Uriostegui | Interpreter | 2117 Edgewood Rd, Waukegan, IL 60087-1442 | 2013-08-29 |
| 1518390871 | Mary Sol Enriquez | Developmental Therapist | 11307 W Edgewood Rd, Beach Park, IL 60087-1526 | 2013-08-09 |
| 1649894130 | Kelly M Ingram | Developmental Therapist | 38229 N North Ave, Beach Park, IL 60087-1662 | 2020-06-01 |
| 1467735209 | Kelly A. Holverson | Speech-Language Pathologist | 38286 N Geraghty Ave, Beach Park, IL 60087-1748 | 2011-09-27 |
| 1487669594 | Walgreen Co | Pharmacy | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2006-07-29 |
| 1568744787 | Carol Comstock | Pharmacist | 39023 N Green Bay Rd, Beach Park, IL 60087-1978 | 2011-09-14 |
| Find all providers in zip 60087 | ||||
| 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 |
|---|---|---|---|---|
| 1124629076 | Align Dental Group PC. | Dentist | 2605 Grand Ave Ste A, Waukegan, IL 60085-2410 | 2020-11-06 |
| 1326596339 | Alla Kahn, Dds, Ltd | Dentist | 935 W Glen Flora Ave, Suite 200, Waukegan, IL 60085-1899 | 2016-09-19 |
| 1518321124 | Salud Dental of Waukegan | Dentist | 2320 Grand Ave, Waukegan, IL 60085-3313 | 2016-04-09 |
| 1205004082 | Divinia G. Catabijan | Dentist | 1711 W Monroe St, Waukegan, IL 60085-3527 | 2008-02-14 |
| 1457475287 | Richard B. Kirchhoff | Dentist | 2634 Grand Avenue, #106, Waukegan, IL 60085 | 2007-03-19 |
| 1447390182 | Kathleen Regina Woods | Dentist | 191 N Greenbay Rd, Waukegan, IL 60085 | 2007-02-08 |
| 1306955075 | Ellis J Neiburger | Dentist | 1000 North Ave, Waukegan, IL 60085-2938 | 2006-08-29 |
| 1730792359 | Jason Abraham | Dentist | 2821 Grand Ave, Waukegan, IL 60085-2372 | 2020-08-24 |
| 1417440611 | Amdental Inc | Dentist | 1421 N Lewis Ave, Waukegan, IL 60085-1757 | 2018-06-12 |
| 1336677665 | Yonghwi Moon | Dentist | 2821 Grand Ave, Waukegan, IL 60085 | 2017-05-31 |
| Find all providers in WAUKEGAN | ||||
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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.