DR. SPENCER FULLMER D.D.S.
NPI 1962707208
Dentist - Endodontics in Columbus, OH

Q: What is Spencer Fullmer's NPI number?

The NPI number for Spencer Fullmer is 1962707208. It was assigned to this individual provider in the NPPES registry on January 18, 2011.

Q: What is Spencer Fullmer's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: Is Spencer Fullmer enrolled in Medicare?

No. Spencer Fullmer has opted out of Medicare through June 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Spencer Fullmer was last updated on January 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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 January 18, 2011Opted out of Medicare · through Jun 17, 2027

305 W 12TH AVE, COLUMBUS, OH 43210(614) 292-5399(614) 688-3608 Get Directions Write a Review

NPPES record last updated: January 18, 2011. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Spencer Fullmer D.d.s. NPPES

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

DR. SPENCER FULLMER D.D.S. (NPI 1962707208) is an individual endodontics provider in Columbus, Ohio, licensed in Ohio (RES.3003) and active in the NPI registry since January 2011. He has opted out of Medicare through June 17, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1962707208

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameDR. SPENCER FULLMERCredential: D.D.S.

Location Address305 W 12TH AVEColumbus, OH 43210-1267

Mailing Address1329 Bluffton CtColumbus, OH 43228-9186 · (614) 209-8920

Phone(614) 292-5399

Fax(614) 688-3608

Sole ProprietorYes

Enumeration DateJanuary 18, 2011

✔ NPI 1962707208 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

License✔ Licensed in OH · RES.3003

Definition

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

305 W 12TH AVE, Columbus, OH 43210

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama and more.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. Spencer Fullmer 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 June 17, 2015 through June 17, 2027.

Opt-Out Effective DateJune 17, 2015

Opt-Out In Effect ThroughJune 17, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 43210 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

$84.72 typical visit price

range $54.34 – $166.65

Typical copayment $21.18 (range $13.58 – $41.66)

Most-billed visit code 99203

Established Patient

$68.07 typical visit price

range $17.10 – $135.40

Typical copayment $17.01 (range $4.27 – $33.85)

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.

DR. TIMOTHY GARTH WEAVER D.D.S.

Dentist

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (614) 292-7473

MITCHELL THAI

Dentist (General Practice)

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (614) 292-4468

DIANA MAHMOODI DMD

Dentist (Prosthodontics)

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (703) 608-6431

DR. ELMER JAY NEWNESS D.D.S.

Dentist

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (614) 292-3015

DANIEL STENTZ D.D.S.

Dentist

305 W 12TH AVE, ROOM 3059C POSTLE HALL
COLUMBUS, OH 43210

Franklin County (614) 292-3596

JENNIFER BURZYNSKI DMD

Dentist (Orthodontics and Dentofacial Orthopedics)

305 W 12TH AVE, OSU DEPARTMENT OF ORTHODONTICS
COLUMBUS, OH 43210

Franklin County (614) 292-9100

DR. SOORYA SRINIVASAN D.M.D

Dentist (Orthodontics and Dentofacial Orthopedics)

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (614) 688-4047

DR. BRYCE WOOLSEY DDS

Dentist

305 W 12TH AVE
COLUMBUS, OH 43210

Franklin County (614) 292-2622

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 Spencer Fullmer's NPI number?

The NPI number for Spencer Fullmer is 1962707208. It was assigned to this individual provider in the NPPES registry on January 18, 2011.

Where is Spencer Fullmer located?

Spencer Fullmer practices at 305 W 12th Ave, Columbus, OH 43210. The listed phone number is (614) 292-5399.

What is Spencer Fullmer's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Is Spencer Fullmer enrolled in Medicare?

No. Spencer Fullmer has opted out of Medicare through June 17, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

What insurance does Spencer Fullmer accept?

Health plans from Ambetter from Arizona Complete Health, Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 5 other insurers list Spencer Fullmer 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 Spencer Fullmer was last updated on January 18, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.