DR. BENJAMIN LUKE FULLER D.D.S.
NPI 1689802910
Dentist - Oral and Maxillofacial Surgery in Cedar Rapids, IA

Active since June 25, 2009Opted out of Medicare · through Aug 5, 2027
835 3RD AVE SW, CEDAR RAPIDS, IA 52404(319) 366-8377(319) 366-7091 Get Directions Write a Review

NPPES record last updated: July 2, 2013. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Benjamin Luke Fuller D.d.s. NPPES

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

DR. BENJAMIN LUKE FULLER D.D.S. (NPI 1689802910) is an individual oral and maxillofacial surgery provider in Cedar Rapids, Iowa, licensed in Iowa (08986) and active in the NPI registry since June 2009. He has opted out of Medicare through August 5, 2027.

NPPES Registry Identity

NPI1689802910
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. BENJAMIN LUKE FULLERCredential: D.D.S.
Location Address835 3RD AVE SWCedar Rapids, IA 52404-1810
Mailing Address2825 Rosebay CtCedar Rapids, IA 52411-4701 · (319) 321-1486
Fax(319) 366-7091
Sole ProprietorNo
Enumeration DateJune 25, 2009
Last NPPES UpdateJuly 2, 2013
NPI 1689802910 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
Licenses Licensed in IA · 08986 Licensed in OK · 6128
Definition
An oral and maxillofacial surgery dentist specialized in 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.
835 3RD AVE SW, Cedar Rapids, IA 52404

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Opted out of Medicare

Dr. Benjamin Luke Fuller D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from August 5, 2013 through August 5, 2027.

Opt-Out Effective DateAugust 5, 2013
Opt-Out In Effect ThroughAugust 5, 2027Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Benjamin Fuller's NPI number?

The NPI number for Benjamin Fuller is 1689802910. It was assigned to this individual provider in the NPPES registry on June 25, 2009.

Where is Benjamin Fuller located?

Benjamin Fuller practices at 835 3rd Ave SW, Cedar Rapids, IA 52404. The listed phone number is (319) 366-8377.

What is Benjamin Fuller's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Benjamin Fuller enrolled in Medicare?

No. Benjamin Fuller has opted out of Medicare through August 5, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Benjamin Fuller accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Delta Dental of Iowa list Benjamin Fuller as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Benjamin Fuller was last updated on July 2, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 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.