Individual provider · Type 1 NPI

Ian Jacob Fullinfaw, DDS

General Practice Dentistry · Council Bluffs, IA

NPI number 1861187205 Active

Practice location

1026 Woodbury Ave
Council Bluffs, IA 51503-7915

Call (712) 201-8891 Map

Mailing address

15711 Lakeside Cir
Omaha, NE 68135-1103

Other practice locations

  • 14133 Q St, Omaha, NE 68137-2600 · (402) 506-5100

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program 390200000X13750 (CT)
General Practice Dentistry Primary 1223G0001XDDS-10256 (IA)
General Practice Dentistry 1223G0001X7932 (NE)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

6 other providers at this address

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About NPI 1861187205

Ian Jacob Fullinfaw, DDS's National Provider Identifier is 1861187205, issued on Apr 11, 2023. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Council Bluffs, IA. The record was last updated on Oct 16, 2024.