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Dorothy Ilert Fuller , MBA

Physician β€’ Fresno, CA

Deactivated NPI 1508545492 Deactivated in NPPES Female Practitioner
Practice location in NPPES

9439 N Saybrook Dr Apt 228
Fresno, CA 937200636

Phone: 6155253523

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.

This NPI Is Deactivated in NPPES

NPPES lists this NPI as deactivated as of July 24, 2025; the reason is not published. The records below are historical. They do not show whether Dorothy Fuller currently practices or holds a license; check the state medical board for current license status.

NPI Enumeration Date July 17, 2023
NPI Deactivation Date July 24, 2025
NPI Active Period 2023 – 2025

Practice Location & Contact Primary Location

Practice Address

9439 N Saybrook Dr Apt 228

Fresno, CA 937200636

Telephone 6155253523

NPI first issued

2023

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.

Compared with the same specialty in Fresno and California

Comparisons are not shown because NPPES lists this NPI as deactivated.

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

Prosthetic/Orthotic Supplier Primary Specialty

NUCC Taxonomy Code: 335E00000X

An organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.

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: Medical Board of California.
Look Up on State Board Site

Career & Practice History Timeline

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

7 Historical Events
⚠️
NPI Profile Deactivated July 24, 2025

NPPES lists this NPI as deactivated as of July 24, 2025; the reason is not published.

βœ…
NPI Profile Active July 17, 2023

NPI status registered as active in NPPES database

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Practice Location (Initial Record) July 17, 2023

Registered at 9439 N SAYBROOK DR APT 228, FRESNO, CA 937200636 (Tel: 6155253523)

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Business Mailing Address (Initial Record) July 17, 2023

Registered at 9439 N SAYBROOK DR APT 228, FRESNO, CA 937200636 (Tel: 6155253523)

πŸ‘€
Provider Name / Credentials (Initial Record) July 17, 2023

Recorded as DOROTHY FULLER, MBA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 17, 2023

Prosthetic/Orthotic Supplier

🟒
Initial NPI Registration & Enumeration July 17, 2023

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1508545492
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 17, 2023
Last Update: July 17, 2023
Deactivation Date: July 24, 2025

Mailing Address

9439 N Saybrook Dr Apt 228

Fresno, CA 937200636

Phone: 6155253523

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.