NPIMap

Organization Active NPI

Fortress Dental Corporation

  • General Practice Dentistry
  • Elgin, IL
National Provider Identifier
1205169182
Registry record updated Sep 10, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019027676 Issued in IL
Legal business name
FORTRESS DENTAL CORPORATION
Practice address
1350 E. Chicago St
Suite 4
Elgin, IL 60120
Phone
(847) 760-6100
Fax
(847) 760-6101
NPI assigned
Sep 10, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2009

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

Authorized official

Name
Dr. Vu Kong, D.D.SNPI 1548428998
Title
President
Phone
(517) 414-9468

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019027705 IL
General Practice DentistryGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1223G0001X 019027676 IL Primary

Addresses

Primary practice location

1350 E. Chicago St
Suite 4
Elgin, IL 60120

Mailing address

1350 E. Chicago St
Suite 4
Elgin, IL 60120
Phone (847) 760-6100

Other names 1

  • High Point Family Dentistry Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1252540800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1252540800000",
    "number": "1205169182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1350 E. CHICAGO ST",
            "address_2": "SUITE 4",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-760-6100",
            "fax_number": "847-760-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1350 E. CHICAGO ST",
            "address_2": "SUITE 4",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "60120",
            "telephone_number": "847-760-6100",
            "fax_number": "847-760-6101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTRESS DENTAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-10",
        "last_updated": "2009-09-10",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "VU",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-414-9468",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027705",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027676",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "High Point Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 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.