Russell Edward Klein, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

374 E Grand Ave
Student Health Center Sivc
Carbondale, IL 62901

Phone

(618) 536-2421

Fax

(618) 453-3477

NPI assigned

Apr 23, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639397128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "910 IRIS LANE",
            "city": "DU QUOIN",
            "state": "IL",
            "postal_code": "62832",
            "telephone_number": "618-542-2797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "374 E GRAND AVE",
            "address_2": "STUDENT HEALTH CENTER SIVC",
            "city": "CARBONDALE",
            "state": "IL",
            "postal_code": "62901",
            "telephone_number": "618-536-2421",
            "fax_number": "618-453-3477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "RUSSELL",
        "middle_name": "EDWARD",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "016106",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay J King, CNA
• Sharon Melroy Kippenbrock, M.S., CCC-A
• Constance Kirby
• Barsun Kirkman, MD
• Mikhayla Nicole Kleich
• Maureen Jane Klemme, CNP
• Kendra Kline, BA
• Karl M Kochendorfer, MD
• Andrew Jacob Koester, DMD
• Rebecca Konecek, CD

• General Practice Dentistry in Carbondale, IL
• Providers in Carbondale, IL by specialty
• General Practice Dentistry 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.