Derek H Fornelli, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028021 Issued in IL

Practice address

132 N Addison Ave
Elmhurst, IL 60126-2864

Phone

(630) 834-4140

NPI assigned

Aug 20, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Quintessential Dental

  • General Practice Dentistry
  • Elmhurst, IL
  • NPI 1598927733
  NPD (past)

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

{
    "created_epoch": "1250726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250726400000",
    "number": "1093947277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 N ADDISON AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262864",
            "telephone_number": "630-834-4140"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 N ADDISON AVE",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601262864",
            "telephone_number": "630-834-4140"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNELLI",
        "first_name": "DEREK",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-20",
        "last_updated": "2009-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Flor D. Loya DDS LTD
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• Daniel J Fornatto, D.D.S.
• Fortephy Rehab and Fitness, PLLC
• Dale Norman Foster, PHARMACIST
• Fox Lake Fire Department
• Francis E Banich MDSC
• Tracie Francis, LMT

• General Practice Dentistry in Elmhurst, IL
• Providers in Elmhurst, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.