Robert Theodore Klabunde

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14722 Issued in MN

Practice address

8454 Highway 7
St Louis Park, MN 55426-3900

Phone

(952) 933-3667

NPI assigned

Jun 3, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Knollwood Dentistry, PC

  • General Practice Dentistry
  • St. Louis Park, MN
  • NPI 1497149496
  NPD (past)

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

{
    "created_epoch": "1654214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654560000000",
    "number": "1760121073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 PEACEFUL PL",
            "city": "MANKATO",
            "state": "MN",
            "postal_code": "560017414",
            "telephone_number": "507-227-6919"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8454 HIGHWAY 7",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554263900",
            "telephone_number": "952-933-3667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLABUNDE",
        "first_name": "ROBERT",
        "middle_name": "THEODORE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-03",
        "last_updated": "2022-06-07",
        "certification_date": "2022-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14722",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE NUMBER",
            "identifier": "D14722",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "klabu024@umn.edu",
            "affiliation": "N",
            "endpointDescription": "Personal Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "104 Peaceful Pl",
            "city": "Mankato",
            "state": "MN",
            "country_code": "US",
            "postal_code": "560017414",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Anna Therese Kistler
• Lindsay Kitner
• Allyssa Mae Kittock, PA
• Kiza Lash & Beauty Studio LLC
• Margaret L Kjos, C.R.N.A.
• Lauren Elaine Klaers, LMFT
• Victoria Lynn Klaphake
• Alecia Rae Klatt, P.T.
• Morgan Klaustermeier
• Kevin Walter Klee, MD

• General Practice Dentistry in St Louis Park, MN
• Providers in St Louis Park, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2022; 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.