What is Jack Fullwiler's NPI number?

Jack Fullwiler's National Provider Identifier (NPI) is 1518095678, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.

What is Jack Fullwiler's specialty?

Jack Fullwiler is listed in the NPPES registry with a primary specialty of Dentist (Dental Providers).

Where is Jack Fullwiler located?

Jack Fullwiler's practice location on file with NPPES is 1223 N Government Way, Coeur D Alene, ID 83814.

What is Jack Fullwiler's phone number?

The practice phone number listed in the NPPES registry for Jack Fullwiler is (208) 664-9225.

Is Jack Fullwiler's NPI active?

Yes — Jack Fullwiler's NPI (1518095678) is active in the NPPES registry as of the last update on 2007-07-08.

IndividualActive

Jack Fullwiler, DDS

NPI 1518095678 · Dentist · Coeur D Alene, ID

Jack Fullwiler, DDS is a Dentist provider in Coeur D Alene, ID (NPI 1518095678).

Provider details

NPI number: 1518095678
Entity type: Individual
Primary specialty: DentistDental Providers
Credential: DDS
Sex: Male
Sole proprietor: No
License: D1747 (ID)

Specialties & taxonomies

DentistPrimary122300000XLicense D1747 (ID)
Dental Providers

Profile Score

Detailed profile(89/100 index)

A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.

Registry tenure38% of score
19 yrs in NPPES registry
Profile completeness38% of score
100% of core fields populated
Practice footprint23% of score
1 documented practice location

Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.

Practice location

1223 N Government Way

Coeur D Alene, ID 83814

Phone: (208) 664-9225

Fax: (208) 667-3699

Street-level locationGet directions

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Mailing address