Brian Kloberdanz, DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Practice address

1406 Sycamore Rd Ste D
Dekalb, IL 60115-2063

Phone

(815) 758-0633

NPI assigned

Jan 19, 2007

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Kloberdanz Oral Surgery and Dental Implants P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • Dekalb, IL
  • NPI 1225181688
  NPD (past) Authorized official
• Kloberdanz Oral Surgery and Dental Implants P.C.

  • Oral and Maxillofacial Surgery (Dentist)
  • St Charles, IL
  • NPI 1811040298
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1154474328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 SYCAMORE RD STE D",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152063",
            "telephone_number": "815-758-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1406 SYCAMORE RD STE D",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152063",
            "telephone_number": "815-758-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLOBERDANZ",
        "first_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Klein, LCSW
• Sarah Lynn Klein
• Gregg A Kling, D.O.
• Madison Kling
• Kloberdanz Oral Surgery and Dental Implants P.C.
• Olivia Klonoski
• Lisette Kmiec, CCC-SLP
• Joseph A Kmiecik, MD
• Laurie A Knoke, NP
• Nicole Knoles, BA

• Oral and Maxillofacial Surgery (Dentist) in Dekalb, IL
• Providers in Dekalb, IL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.