Provider Type Icon

DR. M. CAMILLE FULLER D.D.S. NPI 1902096720


NPI Information

NPI: 1902096720
Provider Name: DR. M. CAMILLE FULLER, D.D.S.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

PECOS Registration: Yes

Address:
808 W 58TH ST
LOS ANGELES, CA
ZIP 90037
Phone: (323) 541-1600
Get Directions

DR. M. Camille Fuller, D.D.S. is a general practice dentist in Los Angeles, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. M. Camille Fuller, D.D.S. NPI is 1902096720. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

808 W 58TH ST
LOS ANGELES, CA
ZIP 90037-632
Phone: (323) 541-1600
Fax: (323) 541-1499

The NPI 1902096720 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 7/27/2007 and was last updated on 5/2/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice319011093ILLINOISNo
21223G0001XDentistGeneral Practice016112MISSOURIYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.