Individual provider Active NPI

Anna De la Fuente, DMD

  • Dentist
  • Wheeling, IL
National Provider Identifier
1083099733
Registry record updated May 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019030345 Issued in IL
Practice address
282 McHenry Rd
Wheeling, IL 60090-3202
Phone
(847) 235-6859
Fax
(847) 235-6958
NPI assigned
Jul 23, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 019030345 IL Primary

Addresses

Primary practice location

282 McHenry Rd
Wheeling, IL 60090-3202

Mailing address

282 McHenry Rd
Wheeling, IL 60090-3202
Phone (847) 235-6859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150924001797 IL Order and Referring Only - DentistPractitioner - Dentist 6305154329

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
De la Fuente, DMD P.C. Current Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1437609600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463184000000",
    "number": "1083099733",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "282 MCHENRY RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903202",
            "telephone_number": "847-235-6859",
            "fax_number": "847-235-6958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "282 MCHENRY RD",
            "city": "WHEELING",
            "state": "IL",
            "postal_code": "600903202",
            "telephone_number": "847-235-6859",
            "fax_number": "847-235-6958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA FUENTE",
        "first_name": "ANNA",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-07-23",
        "last_updated": "2016-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019030345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wheeling, IL

Sources for this page

Verify at the official NPI Registry.