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Dr. Shane Alan Fuller , DDS

Dentist β€’ Spring Valley, CA

Active NPI 1326450867 Individual Practitioner Male Practitioner
Practice location in NPPES

8788 Jamacha Rd
Spring Valley, CA 919774035

Call 6195152555 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

8788 Jamacha Rd

Spring Valley, CA 919774035

Telephone 6195152555
Organization at the Same NPPES Address or Phone
Family Health Centers Of San Diego, Inc Facility NPI 1508801069

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

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Philadelphia, PA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

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

2014

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

Enrolled in Medicare (PECOS)

Dr. Fuller has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Fuller as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Spring Valley and California

11 active clinicians are listed under Dentist with a practice address in Spring Valley, CA (14,738 in California).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Spring Valley

0% of these 11 clinicians have the CMS telehealth indicator.

0% of these 11 clinicians are listed by CMS as accepting Medicare assignment.

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

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

License # reported to NPPES 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.

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

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

ORDER AND REFERRING ONLY - DENTIST

Medicare Enrollment ID

I20150814014813

Enrollment State Jurisdiction

CA

PECOS Control ID

2365757655

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Not Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

245 N 15th St, Ms467

Philadelphia, PA 191021101

Phone: 2157625643

Clinicians Sharing This Practice Address or Phone

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

7 listed
NPI 1396846036

Doctor of Dental Surgery

NPI 1962436451

Doctor of Medicine (M.D.)

Mario Lopez , PA-C

Physician Assistant - Medical

NPI 1932335080

Physician Assistant (Certified)

NPI 1447749494

Doctor of Medicine (M.D.)

NPI 1992737076

Doctor of Medicine (M.D.)

NPI 1578943858

Doctor of Osteopathic Medicine (D.O.)

Career & Practice History Timeline

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

11 Historical Events
βœ…
NPI Profile Active November 22, 2017

NPI status registered as active in NPPES database

πŸ“
Updated Practice Location November 22, 2017

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

πŸ“
Updated Business Mailing Address November 22, 2017

Registered at 71600 GARDESS RD, RANCHO MIRAGE, CA 922704225

πŸ‘€
Provider Name / Credentials Updated November 22, 2017

Recorded as SHANE FULLER, D.D.S.

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

Dentist (license number reported to NPPES: CA 63426)

βœ…
NPI Profile Active June 02, 2014

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) June 02, 2014

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

πŸ“
Business Mailing Address (Initial Record) June 02, 2014

Registered at 71600 GARDESS RD, RANCHO MIRAGE, CA 922704225

πŸ‘€
Provider Name / Credentials (Initial Record) June 02, 2014

Recorded as SHANE FULLER, D.D.S.

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

Dentist (license number reported to NPPES: CA 63426)

🟒
Initial NPI Registration & Enumeration June 02, 2014

First registered as active Individual Practitioner in NPPES Database.

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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

Other Dentists in Spring Valley

Healthcare providers in Spring Valley

Mailing Address

71600 Gardess Rd

Rancho Mirage, CA 922704225

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.