Individual provider Active NPI

Jill Elizabeth Fenton, D.D.S.

  • General Practice Dentistry
  • Orland Park, IL
National Provider Identifier
1316234297
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019028684 Issued in IL
Practice address
2 Orland Square Dr
Orland Park, IL 60462-3286
Phone
(708) 403-5468
NPI assigned
Jun 29, 2011
Last updated
Jun 29, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019028684 IL Primary

Addresses

Primary practice location

2 Orland Square Dr
Orland Park, IL 60462-3286

Mailing address

PO Box 860036
Minneapolis, MN 55486-7878
Phone (708) 403-5468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
019028684ILMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1309305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1316234297",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 860036",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554867878",
            "telephone_number": "708-403-5468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 ORLAND SQUARE DR",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604623286",
            "telephone_number": "708-403-5468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FENTON",
        "first_name": "JILL",
        "middle_name": "ELIZABETH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-29",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orland Park, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2016; 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.