Kloberdanz Oral Surgery and Dental Implants P.C.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

Legal business name

KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.

Practice address

1406 Sycamore Rd Ste D
Dekalb, IL 60115-2063

Phone

(815) 758-0633

NPI assigned

Jan 19, 2007

Last updated

Dec 11, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Brian Kloberdanz, DDSNPI 1154474328

Title

President

Phone

(630) 377-7077

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Brian Kloberdanz, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Dekalb, IL
  • NPI 1154474328
  NPD (past) Authorized official

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

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449792000000",
    "number": "1225181688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1406 D. SYCAMORE RD",
            "city": "DEKALB",
            "state": "IL",
            "postal_code": "601152063",
            "telephone_number": "815-758-0633",
            "fax_number": "815-758-2638"
        },
        {
            "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": {
        "organization_name": "KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-19",
        "last_updated": "2015-12-11",
        "status": "A",
        "authorized_official_last_name": "KLOBERDANZ",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-377-7077",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blythe H Kitner, AU.D.
• Daniel Klein, LCSW
• Sarah Lynn Klein
• Gregg A Kling, D.O.
• Madison Kling
• Brian Kloberdanz, DDS
• Olivia Klonoski
• Lisette Kmiec, CCC-SLP
• Joseph A Kmiecik, MD
• Laurie A Knoke, NP

• 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 Dec 11, 2015; 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.