DANA E. FENDER, D.M.D., P.C.
Complete NPI Record 1346739372
Dentist - Orthodontics and Dentofacial Orthopedics in Champaign, IL
Active since May 04, 2018
Complete NPI Dataset
This page contains the complete raw NPPES record for Dana E. Fender, D.m.d., P.c. (NPI 1346739372), a dentist organization in Champaign, IL. All 31 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1346739372 Field 1/31
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 2 Field 2/31
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Employer Identification Number EIN: Not available Field 3/31
- The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
- Provider Organization Name Legal Business Name: DANA E. FENDER, D.M.D., P.C. Field 4/31
- The name of the organization provider. If the provider is an organization, this is the legal business name.
- Provider First Line Business Mailing Address: PO BOX 674467 Field 5/31
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: DALLAS Field 6/31
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: TX Field 7/31
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 752674467 Field 8/31
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 9/31
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 2173562222 Field 10/31
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider First Line Business Practice Location Address: 1715 BROADMOOR DR STE A Field 11/31
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: CHAMPAIGN Field 12/31
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: IL Field 13/31
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 618215984 Field 14/31
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 15/31
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 2173562222 Field 16/31
- The telephone number associated with the location address of the provider being identified.
- Authorized Official Last Name: FENDER Field 19/31
- The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
- Authorized Official First Name: DANA Field 20/31
- The first name of the authorized official.
- Authorized Official Middle Name: E Field 21/31
- The middle name of the authorized official.
- Authorized Official Title or Position: OWNER Field 22/31
- The title or position of the authorized official.
- Authorized Official Telephone Number: 2173562222 Field 23/31
- The 10-position telephone number of the authorized official.
- Healthcare Provider Taxonomy Code 1: 1223X0400X Field 24/31
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: 19.031054 Field 25/31
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: IL Field 26/31
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 27/31
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Is Organization Subpart: N Field 28/31
- Indicates whether the provider is a subpart of a larger organization. This is a single-character code: "Y" means the entity is an organizational subpart, while "N" means it is not. Subparts typically include hospital departments, clinics, or other distinct units that fall under a parent organization.
- Authorized Official Credential Text: DMD Field 29/31
- The professional credential(s) of the authorized official listed on the provider's NPI record. Examples include MD (Doctor of Medicine), DO (Doctor of Osteopathy), RN (Registered Nurse), DDS (Doctor of Dental Surgery), PhD, or other recognized designations that reflect the official's qualifications.
- Healthcare Provider Taxonomy Group 1: 193400000X MULTIPLE SINGLE SPECIALTY GROUP Field 30/31
- Specifies whether the provider is part of a single-specialty or multi-specialty business group. The possible values are: 193200000X – Multi-Specialty Group or 193400000X – Single Specialty Group. This field helps distinguish the organizational structure of a provider group.
Secondary Practice Locations 14
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
1607 18th St
Location 1/14Charleston, IL 61920-3606 · Phone (217) 348-0424
3108 W DeYoung St Ste A
Location 2/14Marion, IL 62959-5548 · Phone (618) 997-6640
715 N Giant City Rd Ste 3
Location 3/14Carbondale, IL 62902-6401 · Phone (618) 549-2100
116 W Willow Ave
Location 4/14Wheaton, IL 60187-5276 · Phone (630) 668-0197
1129 Randall Ct
Location 5/14Geneva, IL 60134-3911 · Phone (630) 232-2277
1640 Capital St Ste 500
Location 6/14Elgin, IL 60124-8078 · Phone (847) 289-8800
34 N Island Ave Ste A
Location 7/14Batavia, IL 60510-1996 · Phone (630) 879-8707
2320 Esplanade Dr
Location 8/14Algonquin, IL 60102-5448 · Phone (847) 854-1873
70 S Constitution Dr Ste 102
Location 9/14Aurora, IL 60506-7343 · Phone (630) 896-5400
484 Briargate Dr Unit 101
Location 10/14South Elgin, IL 60177-2225 · Phone (847) 289-8800
12 S Roselle Rd
Location 11/14Schaumburg, IL 60193-5542 · Phone (847) 289-8800
895 S State St Ste 303
Location 12/14Hampshire, IL 60140-9600 · Phone (847) 289-8800
450 Green Bay Rd
Location 13/14Kenilworth, IL 60043-1074 · Phone (847) 251-6228
4777 IL-71
Location 14/14Oswego, IL 60543 · Phone (630) 554-9447
No registry entries match your active lookup criteria.
