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

Ian Jacob Fullinfaw, DDS

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1861187205

Ian Jacob Fullinfaw, DDS is a Student in an Organized Health Care Education/Training Program in Council Bluffs, Iowa. Works from 2 locations. Licensed in Connecticut, Iowa and Nebraska.

Licensed in
CT, IA, NE
In the registry since
2023
Specialties on file
3
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

See every abbreviation used in this directory →

Practice location Address checks out

Student / training record This NPI belongs to someone enrolled in a health care training programme. It carries no licence and no practice of its own, so no address or phone number is published for it.

Council Bluffs, IA

Additional practice locations (1)

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

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DDS-10256 (IA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X · Licence 13750 (CT)
General Practice Dentistry Taxonomy 1223G0001X · Licence 7932 (NE)

Record details

NPI number1861187205
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedApril 11, 2023
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024

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