Individual provider Active NPI

Daniel J Fornatto, D.D.S.

  • General Practice Dentistry
  • Elmhurst, IL
National Provider Identifier
1447213459
Registry record updated Aug 28, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
019022640 Issued in IL
Practice address
917 S York Rd
Elmhurst, IL 60126-5114
Phone
(630) 833-8088
Fax
(630) 833-0112
NPI assigned
Apr 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2007

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 019022640 IL Primary

Addresses

Primary practice location

917 S York Rd
Elmhurst, IL 60126-5114

Mailing address

917 S York Rd
Elmhurst, IL 60126-5114
Phone (630) 833-8088

Other identifiers 1

IdentifierTypeStateIssuer
36-4091746OtherILTAX IDENTIFICATION NUMBER

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
I20150618001320 IL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2466616461

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel J Fornatto D D S P C General Practice PastSince Apr 19, 2012 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": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188259200000",
    "number": "1447213459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "917 S YORK RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265114",
            "telephone_number": "630-833-8088",
            "fax_number": "630-833-0112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "917 S YORK RD",
            "city": "ELMHURST",
            "state": "IL",
            "postal_code": "601265114",
            "telephone_number": "630-833-8088",
            "fax_number": "630-833-0112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORNATTO",
        "first_name": "DANIEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2007-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019022640",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "36-4091746",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, IL

Sources for this page

Verify at the official NPI Registry.