Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1326450867 Individual Practitioner Male Practitioner

Dr. Shane Alan Fuller , DDS

Dentist • Spring Valley, CA

Professional Overview & Biography Verified Profile Summary

Dr. Shane Fuller, DDS is a registered healthcare professional specializing in Dentist in Spring Valley, CA. Practice services are available at 8788 JAMACHA RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

8788 Jamacha Rd

Spring Valley, CA 919774035

Telephone 6195152555
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Spring Valley, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
11 Specialists

Practicing in Spring Valley, CA (15331 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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 63426

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.

Secondary Practice Locations

245 N 15th St, Ms467

Philadelphia, PA 191021101

Phone: 2157625643

Practice Associates & Co-Workers

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

12 Associated Practitioners
Andrea Padilla , LCSW

Social Worker - Clinical

NPI 1093260887

Licensed Clinical Social Worker

Alejandra Wilder , SUDRC

Counselor - Addiction (Substance Use Disorder)

NPI 1104539675
NPI 1396846036

Doctor of Dental Surgery

NPI 1447749494

Doctor of Medicine (M.D.)

NPI 1578943858

Doctor of Osteopathic Medicine (D.O.)

NPI 1588853352

Doctor of Dental Medicine

Career & Practice History Timeline

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

11 Historical Events
NPI Profile Active November 22, 2017

NPI status registered as active in NPPES database

📍
Updated Practice Location November 22, 2017

Registered at 8788 JAMACHA RD, SPRING VALLEY, CA 919774035 (Tel: 6195152555)

📍
Updated Business Mailing Address November 22, 2017

Registered at 71600 GARDESS RD, RANCHO MIRAGE, CA 922704225

👤
Provider Name / Credentials Updated November 22, 2017

Recorded as SHANE FULLER, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) November 22, 2017

Dentist (License #63426 in CA)

NPI Profile Active June 02, 2014

NPI status registered as active in NPPES database

📍
Updated Practice Location June 02, 2014

Registered at 245 N 15TH ST, MS467, PHILADELPHIA, PA 191021101 (Tel: 2157625643)

📍
Updated Business Mailing Address June 02, 2014

Registered at 71600 GARDESS RD, RANCHO MIRAGE, CA 922704225

👤
Provider Name / Credentials Updated June 02, 2014

Recorded as SHANE FULLER, D.D.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 02, 2014

Dentist (License #63426 in CA)

🟢
Initial NPI Registration & Enumeration June 02, 2014

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: 1326450867
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 02, 2014
Last Update: March 17, 2018
Sole Proprietor: No

Mailing Address

71600 Gardess Rd

Rancho Mirage, CA 922704225

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.