PERFORMACE DENTAL CARE IL PC
NPI 1497175988
Dentist in Flossmoor, IL

Active since April 23, 2014
19509 GOVERNORS HWY, FLOSSMOOR, IL 60422(708) 647-7509 Get Directions Write a Review

NPPES record last updated: April 23, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

  • Organization
  • Dentist

About PERFORMACE DENTAL CARE IL PC

This page provides the complete NPI Profile along with additional information for Performace Dental Care Il Pc, a provider established in Flossmoor, Illinois operating as a Dentist. The healthcare provider is registered in the NPI registry with number 1497175988 assigned on April 2014. The practitioner's primary taxonomy code is 122300000X with license number 19025070 (IL). The provider is registered as an organization and their NPI record was last updated 12 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Kevin Fatland (Dentist)

NPI
1497175988 Verify this NPI
Provider Name
PERFORMACE DENTAL CARE IL PC
Entity Type
Organization
Location Address
19509 GOVERNORS HWY FLOSSMOOR, IL 60422
Location Phone
(708) 647-7509
Mailing Address
19509 GOVERNORS HWY FLOSSMOOR, IL 60422
Mailing Phone
(708) 647-7509
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
04-23-2014
Last Update Date
04-23-2014
Code Navigator

A dentist like Performace Dental Care Il Pc is a skilled in and licensed provider that diagnoses and treats problems with patients teeth, gums, and related parts of the mouth. Dentists educate patients on how to take care of the teeth and gums and provide information on diet choices that affect oral health. Dentists must be licensed in the state in which they work.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Dentist

Taxonomy Code
122300000X
Type
Dental Providers
License No.
19025070
License State
IL
Taxonomy Description
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

KEVIN FATLAND

Authorized Official Title
DENTIST
Authorized Official Phone
(708) 647-7509

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Other Providers at the Same Location


The following 3 providers are registered at the same or a nearby location.

Dentist (General Practice)
19509 GOVERNORS HWY
FLOSSMOOR, IL 60422
Dentist (General Practice)
19509 GOVERNORS HWY
FLOSSMOOR, IL 60422
Dentist (General Practice)
19509 GOVERNORS HWY
FLOSSMOOR, IL 60422

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1497175988, enumerated as an "organization" on April 23, 2014.

The provider is located at 19509 GOVERNORS HWY FLOSSMOOR, IL 60422 and the phone number is (708) 647-7509.

Dentist with taxonomy code 122300000X.