Dr Kehinde John Fasanya, DDS in Rockford, IL

Dr Kehinde John Fasanya, DDS is a medicare enrolled "Dentist" provider in Rockford, Illinois. His current practice location is 6215 E State St, Rockford, Illinois. You can reach out to his office (for appointments etc.) via phone at (920) 838-1649.

Dr Kehinde John Fasanya is licensed to practice in Illinois (license number 019.028443) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1184939076.

Contact Information

	Dr Kehinde John Fasanya, DDS
	6215 E State St, Rockford, IL 61108-2514
	(920) 838-1649
	Not Available

Map and Direction

Healthcare Provider's Profile

Full Name	Dr Kehinde John Fasanya
Gender	Male
Speciality	Dentist
Location	6215 E State St, Rockford, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1184939076
Provider Enumeration Date: 08/16/2010
Last Update Date: 04/23/2021

Medicare PECOS Information:

PECOS PAC ID: 1759671076
Enrollment ID: I20190910002561

Medical Identifiers

Medical identifiers for Dr Kehinde John Fasanya such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184939076	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	019.028443 (Illinois)	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kehinde John Fasanya allows following entities to bill medicare on his behalf.

Entity Name	Northwestern Medical Faculty Foundation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1346235314 PECOS PAC ID: 4587576814 Enrollment ID: O20031105000541

Entity Name	Cook County
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1588612832 PECOS PAC ID: 2860398088 Enrollment ID: O20031209000747

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kehinde John Fasanya is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kehinde John Fasanya, DDS 430 W Erie St Ste 200, Chicago, IL 60654-6920 Ph: (920) 838-1649	Dr Kehinde John Fasanya, DDS 6215 E State St, Rockford, IL 61108-2514 Ph: (920) 838-1649

Reviews and Comments

Dentist in Rockford, IL

Mr. Edward Paul Rentschler, DDS Dentist Medicare: Medicare Enrolled Practice Location: 449 Roxbury Road, Rockford, IL 61107 Phone: 815-226-4700 Fax: 815-391-5188
Dr. Wei Gao, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 318 College Ave, Rockford, IL 61104 Phone: 815-965-5555 Fax: 815-965-5561
Dr. Thomas Ryan Moss, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1415 E State Street, Rockford, IL 61104 Phone: 815-964-5121 Fax: 815-964-6105
Dr. Saseelan Sivagnanam, BDS Dentist Medicare: Medicare Enrolled Practice Location: 7318 Argus Dr, Rockford, IL 61107 Phone: 815-207-8759
Yangbasai Dong, Dentist Medicare: Not Enrolled in Medicare Practice Location: 5819 E Riverside Blvd # 21, Rockford, IL 61114 Phone: 815-282-4311 Fax: 815-282-4315
Dr. Julia R Pesavento, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 1075 Featherstone Rd Ste 30, Rockford, IL 61107 Phone: 815-395-1711 Fax: 815-395-1705
Dr. Thomas Lee, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 1200 W State St, Rockford, IL 61102 Phone: 815-490-1601 Fax: 815-490-1625

Dr Kehinde John Fasanya, DDS - Medicare Dentist in Rockford, IL