DANA E. FENDER, D.M.D., P.C. (NPI# 1346739372) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346739372 |
| Entity Type | Organization |
| Organization Name | DANA E. FENDER, D.M.D., P.C. |
| Practice Address |
1715 Broadmoor Dr Ste A Champaign IL 61821-5984 |
| Mailing Address |
Po Box 674467 Dallas TX 75267-4467 |
| Practice Telephone | 2173562222 |
| Mailing Telephone | 2173562222 |
| Enumeration Date | 2018-05-04 |
| Last Update Date | 2020-10-13 |
| Authorized Official Name | DANA E FENDER (OWNER) |
| Authorized Official Telephone | 2173562222 |
| Authorized Official Credential | DMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
19.031054 | IL | Dental Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1129 Randall Ct, Geneva, IL 601343911 | 6302322277 | |
| 116 W Willow Ave, Wheaton, IL 601875276 | 6306680197 | |
| 12 S Roselle Rd, Schaumburg, IL 601935542 | 8472898800 | |
| 1607 18th St, Charleston, IL 619203606 | 2173480424 | |
| 1640 Capital St Ste 500, Elgin, IL 601248078 | 8472898800 | |
| 2320 Esplanade Dr, Algonquin, IL 601025448 | 8478541873 | |
| 3108 W Deyoung St Ste A, Marion, IL 629595548 | 6189976640 | |
| 34 N Island Ave Ste A, Batavia, IL 605101996 | 6308798707 | |
| 450 Green Bay Rd, Kenilworth, IL 600431074 | 8472516228 | |
| 4777 Il-71, Oswego, IL 60543 | 6305549447 | |
| 484 Briargate Dr Unit 101, South Elgin, IL 601772225 | 8472898800 | |
| 70 S Constitution Dr Ste 102, Aurora, IL 605067343 | 6308965400 | |
| 715 N Giant City Rd Ste 3, Carbondale, IL 629026401 | 6185492100 | |
| 895 S State St Ste 303, Hampshire, IL 601409600 | 8472898800 |
| Street Address |
1715 BROADMOOR DR STE A |
| City | CHAMPAIGN |
| State | IL |
| Zip Code | 61821-5984 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316580384 | Zesheng Chen | Dentist | 1715 Broadmoor Dr Ste A, Champaign, IL 61821-5984 | 2019-10-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326532888 | Cunningham Children's Home of Urbana Il | Residential Treatment Facility, Emotionally Disturbed Children | 1303 N. Cunningham Avenue, Urbana, IL 61821 | 2018-06-19 |
| 1184008708 | Seunghyun Jae | Dentist | 1905 W Springfield Ave, Champaign, IL 61821 | 2015-07-14 |
| 1457698169 | Mohamad Ata | Registered Nurse | 1802 S. Mattis, Champaign, IL 61821 | 2013-01-15 |
| 1609124338 | Lolitia Rosanna Newman | Social Worker | 1508 Powers Ln., Champaign, IL 61821 | 2012-08-28 |
| 1679850887 | Kirk Donald Gohsman | Counselor | 106 S. Country Fair Drive, Suite C, Champaign, IL 61821 | 2011-11-16 |
| 1598054777 | Delbert William Nelson Jr. | Psychiatry & Neurology | 2115 Galen Dr, Champaign, IL 61821 | 2011-03-28 |
| 1790946929 | Rdi Vein LLC | Clinic/Center | 2502 Galen Drive, Suite 101, Champaign, IL 61821 | 2008-06-20 |
| 1366620064 | Advanced Aesthetics Surgery & Laser Center, P.C. | Clinic/Center | 2111 West Park Ct., Champaign, IL 61821 | 2008-02-05 |
| 1033398482 | Huey's Home Medical, Inc | Durable Medical Equipment & Medical Supplies | 1207 S Mattis Ave Ste 1, Champaign, IL 61821 | 2007-11-01 |
| 1265630537 | Elizabeth Catherine Tingley | Psychologist | Department of Psychiatry and Psychology-carle Physician, 1802 S. Mattis, Champaign, IL 61821 | 2007-07-06 |
| Find all providers in zip 61821 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033266291 | Christopher N. Jordan | Dentist | 2920 Crossing Ct, Champaign, IL 61822-6163 | 2007-01-03 |
| 1508960170 | Robert William Shafer | Dentist | 2902 Crossing Ct, Suite A, Champaign, IL 61822-6175 | 2006-09-12 |
| 1710090444 | William John Mccabe Jr. | Dentist | 1715 Broadmoor Dr, Suite A, Champaign, IL 61821-5983 | 2006-08-16 |
| 1689686735 | Mark Huls | Dentist | 481 Devonshire Dr, Champaign, IL 61820-7230 | 2006-08-13 |
| 1730372012 | Heartland Family Dental Care of Illinois, PC | Dentist | 314 W Kirby Ave, Champaign, IL 61820-7208 | 2007-08-21 |
| 1376663799 | Gene Paul King | Dentist | 701 Devonshire Dr, Champaign, IL 61820-7337 | 2007-03-30 |
| 1184728768 | Robert W Shafer Dds Ltd | Dentist | 2902 Crossing Ct, Suite A, Champaign, IL 61822-6175 | 2006-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427670421 | Braces By Barnes | Dentist | 1335 E 87th St Ste B, Chicago, IL 60619-7036 | 2020-05-12 |
| 1790310431 | Gregory D Long II | Dentist | 7131 N Knoxville Ave Ste B, Peoria, IL 61614-2088 | 2020-03-03 |
| 1073147682 | Collinsville Orthodontics Pllc | Dentist | 93 Crestmoor St, Collinsville, IL 62234-4952 | 2020-02-24 |
| 1740812494 | Bankhead Alton Orthodontics PC | Dentist | 2828 Homer Adams Pkwy, Alton, IL 62002-4855 | 2020-02-11 |
| 1336779164 | Orthodontic Experts, Ltd | Dentist | 2987 Kirk Rd Ste 103a, Aurora, IL 60502-6014 | 2020-01-21 |
| 1922645308 | Riddhi J Desai Dmd Pllc | Dentist | 727 W Madison St Apt 1208, Chicago, IL 60661-2409 | 2019-12-04 |
| 1295379691 | Orthodontic Experts, Ltd | Dentist | 1351 N Larkin Ave, Joliet, IL 60435-3753 | 2019-10-30 |
| 1407409071 | Barysenka LLC | Dentist | 124 N California St, Sycamore, IL 60178-1402 | 2019-07-22 |
| 1346806577 | Pulaski Smiling Dental P.C. | Dentist | 5540 S Pulaski Rd Fl 1, Chicago, IL 60629-4418 | 2019-05-13 |
| 1750944252 | Candid Illinois, Pllc | Dentist | 750 N Franklin St Fl Stc2, Chicago, IL 60654-6263 | 2019-04-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.