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KANKAKEE DENTAL PLLC
NPI 1780256503
Clinic/Center - Dental in Kankakee, IL

Active since July 12, 2021
200 E COURT ST STE 504, KANKAKEE, IL 60901(815) 932-3613 Get Directions Write a Review

NPPES record last updated: July 12, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kankakee Dental Pllc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KANKAKEE DENTAL PLLC (NPI 1780256503) is a healthcare organization registered as a dental in Kankakee, Illinois and active in the NPI registry since July 2021. The organization lists Kevin Fatland, Member, as its authorized official.

NPPES Registry Identity

NPI1780256503
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameKANKAKEE DENTAL PLLC
Location Address200 E COURT ST STE 504Kankakee, IL 60901-3847
Mailing Address200 E Court St Ste 504Kankakee, IL 60901-3847 · (815) 932-3613
Phone(815) 932-3613
Organization SubpartNo
Authorized OfficialKevin FatlandMember · (708) 990-7869
Enumeration DateJuly 12, 2021
NPPES CertifiedJuly 12, 2021
✔ NPI 1780256503 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
200 E COURT ST STE 504, Kankakee, IL 60901
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kankakee Dental PLLC's NPI number?

The NPI number for Kankakee Dental PLLC is 1780256503. It was assigned to this organization in the NPPES registry on July 12, 2021.

Where is Kankakee Dental PLLC located?

Kankakee Dental PLLC is located at 200 E Court St Ste 504, Kankakee, IL 60901. The listed phone number is (815) 932-3613.

What is Kankakee Dental PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Kankakee Dental PLLC was last updated on July 12, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.