Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1922853878 Individual Practitioner Male Practitioner

Peter Fullmer

Dentist - General Practice • Eielson Afb, AK

Professional Overview & Biography Verified Profile Summary

Peter Fullmer is a registered healthcare professional specializing in Dentist - General Practice in Eielson Afb, AK. Practice services are available at 2630 CENTRAL AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2630 Central Ave

Eielson Afb, AK 997022301

Telephone 9073771847
Associated Practice Facility / Clinic
🏢 354th Medgrp-Eielson Facility NPI 1902867229

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Eielson Afb, AK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 4.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Eielson Afb, AK (346 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2025-08-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License UT 14004164-9926

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.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

10 Associated Practitioners
Nichole Kilinc , PA-C

Physician Assistant - Medical

NPI 1144984592

Physician Assistant (Certified)

NPI 1174864904

Doctor of Optometry

Gretchen Casci , APRN, FNP-C

Nurse Practitioner - Family

NPI 1407324999

Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified)

NPI 1417532102

Doctor of Osteopathic Medicine (D.O.)

Mark Pulver , SOCIAL WORKER (LCSW)

Social Worker - Clinical

NPI 1538797279

SOCIALWORKER(LCSW)

NPI 1578545109

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location August 12, 2025

Registered at 2630 CENTRAL AVE, EIELSON AFB, AK 997022301 (Tel: 9073771847)

📍
Updated Business Mailing Address August 12, 2025

Registered at 2630 CENTRAL AVE, EIELSON AFB, AK 997022301

📍
Updated Practice Location August 14, 2024

Registered at 4881 SUGAR MAPLE DR, WRIGHT PATTERSON AFB, OH 454335529 (Tel: 5094145333)

NPI Profile Active April 23, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location April 23, 2024

Registered at 188 LONGWOOD AVE, BOSTON, MA 021155819 (Tel: 5094145333)

📍
Updated Business Mailing Address April 23, 2024

Registered at 3447 STONEY CREEK ST, SPRINGFIELD, OH 455044367 (Tel: 5094145333)

👤
Provider Name / Credentials Updated April 23, 2024

Recorded as PETER FULLMER

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 23, 2024

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration April 23, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1922853878
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 23, 2024
Last Update: August 12, 2025
Sole Proprietor: No

Mailing Address

2630 Central Ave

Eielson Afb, AK 997022301

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.