SHANE ALAN FULLER D.D.S.
NPI 1326450867
Dentist in Spring Valley, CA

Q: What is Shane Fuller's NPI number?

The NPI number for Shane Fuller is 1326450867. It was assigned to this individual provider in the NPPES registry on June 2, 2014.

Q: What is Shane Fuller's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Shane Fuller was last updated on March 17, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 02, 2014PECOS Enrolled

8788 JAMACHA RD, SPRING VALLEY, CA 91977(619) 515-2555 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 17, 2018, Nov 22, 2017, Aug 28, 2017 (3 updates tracked since 2017).

On this page

About Shane Alan Fuller D.d.s. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SHANE ALAN FULLER D.D.S. (NPI 1326450867) is an individual dentist in Spring Valley, California, licensed in California (63426) and active in the NPI registry since June 2014. He is enrolled in Medicare PECOS and maintains a secondary practice location in Philadelphia.

NPPES Registry Identity

NPI1326450867

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameSHANE ALAN FULLERCredential: D.D.S.

Location Address8788 JAMACHA RDSpring Valley, CA 91977-4035

Mailing Address71600 Gardess RdRancho Mirage, CA 92270-4225

Phone(619) 515-2555

Sole ProprietorNo

Enumeration DateJune 2, 2014

Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration

✔ NPI 1326450867 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 63426

Definition

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.

8788 JAMACHA RD, Spring Valley, CA 91977

Open in Google Maps ↗

Secondary Practice Location 1

Location 1245 N 15th St, MS467Philadelphia, PA 19102-1101 · Phone (215) 762-5643

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Shane Alan Fuller D.d.s. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91977 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLYN SYLVIA QUINTERO MD

Pediatrics