Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Grace Fuller, RDH

Individual provider Dental Hygienist · NPI 1104696152

Kelly Grace Fuller, RDH is a Dental Hygienist in Enterprise, Oregon. Licensed in Oregon. Registered with an NPI since 2024.

Licensed in
OR
In the registry since
2024
What do these letters mean?
RDH — Registered Dental Hygienist
A licensed hygienist who cleans teeth and screens for oral disease.

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Practice location Address checks out

603 Medical Pkwy
Enterprise, OR 97828-5124
Phone: (541) 426-4502
Fax: (541) 426-6403
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dental Hygienist (primary) Taxonomy 124Q00000X · Licence H8509 (OR)

Record details

NPI number1104696152
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDH
Sole proprietorNo
NPI enumeratedJanuary 2, 2024
Last updated in NPPESJanuary 2, 2024
Certification dateJanuary 2, 2024
Mailing address603 Medical Pkwy, Enterprise, OR 97828-5124

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