Active NPI
Daniel J Fornatto, D.D.S.
- General Practice Dentistry
- Elmhurst, IL
National Provider Identifier
1447213459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 019022640
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 36-4091746 | Other | IL | TAX 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150618001320 | IL | Order and Referring Only - Oral Surgery | 2466616461 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daniel J Fornatto D D S P C | General Practice | Past | 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.
-
- General Practice Dentistry
- Elmhurst, IL
- NPI 1508050022
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.