Fuller Avenue Dental Associates
NPI 1639397615 · General Practice Dentistry · Grand Rapids, MI
Fuller Avenue Dental Associates is a General Practice Dentistry organization in Grand Rapids, MI (NPI 1639397615).
Provider details
- NPI number
- 1639397615
- Entity type
- Organization
- Primary specialty
- General Practice DentistryDental Providers
- Organization subpart
- No
- Authorized official
- Shannon Visscher-Worst, Office Manager(616) 363-1136
- License
- 10428 (MI)
Specialties & taxonomies
Dental Providers
Dental Providers
Profile Score
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
Mailing address
Registry dates
- Enumerated
- 2007-04-23
- Last updated
- 2020-08-22
Frequently asked questions
- What is Fuller Avenue Dental Associates's NPI number?
- Fuller Avenue Dental Associates's National Provider Identifier (NPI) is 1639397615, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Fuller Avenue Dental Associates?
- Fuller Avenue Dental Associates is classified in the NPPES registry as General Practice Dentistry (Dental Providers).
- Where is Fuller Avenue Dental Associates located?
- Fuller Avenue Dental Associates's practice location on file with NPPES is 2755 Fuller Ave Ne, Grand Rapids, MI 49505-3780.
- What is Fuller Avenue Dental Associates's phone number?
- The practice phone number listed in the NPPES registry for Fuller Avenue Dental Associates is (616) 363-1136.
- Who is the authorized official for Fuller Avenue Dental Associates?
- The authorized official listed on Fuller Avenue Dental Associates's NPPES record is Shannon Visscher-Worst, Office Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Fuller Avenue Dental Associates's NPI active?
- Yes — Fuller Avenue Dental Associates's NPI (1639397615) is active in the NPPES registry as of the last update on 2020-08-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.