Paul David Vander Kelen, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

WI 2484 Issued in WI

Practice address

2313 S. Webster Avenue
Green Bay, WI 54301-2194

Phone

(920) 432-8492

Fax

(920) 432-6141

NPI assigned

May 27, 2005

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

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1117152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1295738854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3934 SAINT CROIX CIR E",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543011075",
            "telephone_number": "920-337-0970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2313 S. WEBSTER AVENUE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543012194",
            "telephone_number": "920-432-8492",
            "fax_number": "920-432-6141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER KELEN",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "WI 2484",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jamie Vandenhouten, PTA
• Karen Vandenhouten
• Stacy L Vandenput, CPM LICENSED MIDWIFE
• Mackenzie Rose Vander Bloomen, MSN, FNP-C
• Yvonne Vander Heiden, COTA
• Katherine Mary Vander Zanden, APNP
• Katherine Vanderheiden, MAC
• Vanderleest Dental LLC
• Marcus James Vanderleest, DDS
• Diane Lynn Vanderlin, RN MSN APNP C

• General Practice Dentistry in Green Bay, WI
• Providers in Green Bay, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.