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Peter Fullmer

Dentist - General Practice β€’ Eielson Afb, AK

Active NPI 1922853878 Individual Practitioner Male Practitioner
Practice location in NPPES

2630 Central Ave
Eielson Afb, AK 997022301

Call 9073771847 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

2630 Central Ave

Eielson Afb, AK 997022301

Telephone 9073771847
Organization at the Same NPPES Address or Phone
354th Medgrp-Eielson Facility NPI 1902867229

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Industry payments (Open Payments)

No Open Payments records are listed for this clinician for 2019–2025.

Guide: How to read an Open Payments record

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Eielson Afb and Alaska

4 active clinicians are listed under Dentist - General Practice with a practice address in Eielson Afb, AK (328 in Alaska).

Addresses are self-reported to NPPES and may be out of date.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2025-08-12
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

License # reported to NPPES 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.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Alaska State Medical Licensing Board.
Look Up on State Board Site

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

4 listed
Gretchen Casci , APRN, FNP-C

Nurse Practitioner - Family

NPI 1407324999

Advanced Practice Registered Nurse, Family Nurse Practitioner (Certified)

NPI 1174864904

Doctor of Optometry

NPI 1578545109

Doctor of Medicine (M.D.)

Katherine Willett , PA-C

Physician Assistant

NPI 1700320553

Physician Assistant (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location August 12, 2025

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

πŸ“
Updated Business Mailing Address August 12, 2025

Registered at 2630 CENTRAL AVE, EIELSON AFB, AK 997022301

πŸ“
Updated Practice Location August 14, 2024

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

βœ…
NPI Profile Active April 23, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 23, 2024

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

πŸ“
Business Mailing Address (Initial Record) April 23, 2024

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

πŸ‘€
Provider Name / Credentials (Initial Record) April 23, 2024

Recorded as PETER FULLMER

πŸŽ“
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.

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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

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.