IndividualActive
Domenick Fuller, DDS
NPI 1649063850 · General Practice Dentistry · Pocatello, ID
Domenick Fuller, DDS is a General Practice Dentistry provider in Pocatello, ID (NPI 1649063850).
Provider details
- NPI number
- 1649063850
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 9271560 (ID)
Specialties & taxonomies
Dental Providers
Profile Score
Established profile(54/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
1 yr 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
921 S 8th Ave
Pocatello, ID 83209-0002
Phone: (208) 282-3289
Street-level locationGet directions
Mailing address
397 E Shepard Ln
Kaysville, UT 84037-9637
Registry dates
- Enumerated
- 2025-05-28
- Last updated
- 2025-06-04
- Certified
- 2025-06-04
Frequently asked questions
- What is Domenick Fuller's NPI number?
- Domenick Fuller's National Provider Identifier (NPI) is 1649063850, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Domenick Fuller's specialty?
- Domenick Fuller is listed in the NPPES registry with a primary specialty of General Practice Dentistry (Dental Providers).
- Where is Domenick Fuller located?
- Domenick Fuller's practice location on file with NPPES is 921 S 8th Ave, Pocatello, ID 83209-0002.
- What is Domenick Fuller's phone number?
- The practice phone number listed in the NPPES registry for Domenick Fuller is (208) 282-3289.
- Is Domenick Fuller's NPI active?
- Yes — Domenick Fuller's NPI (1649063850) is active in the NPPES registry as of the last update on 2025-06-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.