Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730733007 Individual Practitioner Male Practitioner

Dr. Forrest Wane Fullenkamp , DDS

Dentist • Decatur, IN

Professional Overview & Biography Verified Profile Summary

Dr. Forrest Fullenkamp, DDS is a registered healthcare professional specializing in Dentist in Decatur, IN. Practice services are available at 1020 SOUTHAMPTON DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1020 Southampton Dr

Decatur, IN 467331049

Telephone 2607248410
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Decatur, IN

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 7.1 Yrs
Regional Practice Density
7 Specialists

Practicing in Decatur, IN (1682 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: 2024-04-29
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License IN 12013196A

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Indiana Professional Licensing Agency
12013196A (IN)

Secondary Practice Locations

Fort Bragg Dentac

Fort Bragg, NC 283100001

Phone: 2602237533

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Julie Fullenkamp , DDS

Dentist - General Practice

NPI 1548753163

Doctor of Dental Surgery

Dr. Ronald Hammond , DDS

Dentist - General Practice

NPI 1720133176

Doctor of Dental Surgery

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location April 29, 2024

Registered at 1020 SOUTHAMPTON DR, DECATUR, IN 467331049 (Tel: 2607248410)

📍
Updated Business Mailing Address April 29, 2024

Registered at 1020 SOUTHAMPTON DR, DECATUR, IN 467331049 (Tel: 2607248410)

📍
Updated Practice Location August 16, 2022

Registered at FORT BRAGG DENTAC, FORT BRAGG, NC 283100001 (Tel: 2602237533)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 16, 2022

Dentist (License #12013196A in IN)

NPI Profile Active July 25, 2019

NPI status registered as active in NPPES database

📍
Updated Practice Location July 25, 2019

Registered at 5330 MOSEBY ST, COLUMBIA, SC 29207 (Tel: 7518033255)

📍
Updated Business Mailing Address July 25, 2019

Registered at 4323 HILL ST, COLUMBIA, SC 292076022

👤
Provider Name / Credentials Updated July 25, 2019

Recorded as FORREST FULLENKAMP, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 25, 2019

Student in an Organized Health Care Education/Training Program (License #12013196A in IN)

🟢
Initial NPI Registration & Enumeration July 25, 2019

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: 1730733007
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 25, 2019
Last Update: April 29, 2024
Sole Proprietor: No

Mailing Address

1020 Southampton Dr

Decatur, IN 467331049

Phone: 2607248410

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.