Active NPI
Otto Kevin Klanow, D.D.S. M.S.
- Prosthodontics
- Sterling Heights, MI
National Provider Identifier
1801032198
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 2901011910
- Practice address
- 38912 Dequindre
Sterling Heights, MI 48310 - Phone
- (586) 979-4700
- Fax
- (586) 979-9452
- NPI assigned
- Dec 17, 2008
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2901011910 | MI | |
| Prosthodontics | 1223P0700X | 2901011910 | MI | Primary |
Addresses
Primary practice location
38912 Dequindre
Sterling Heights, MI 48310
Mailing address
38912 Dequindre
Sterling Heights, MI 48310
Phone (586) 979-4700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2901011910 | MI | MD | Prosthodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Otto K. Klanow D.D.S. P.C. | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1229472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1229472000000",
"number": "1801032198",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38912 DEQUINDRE",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "48310",
"telephone_number": "586-979-4700",
"fax_number": "586-979-9452"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38912 DEQUINDRE",
"city": "STERLING HEIGHTS",
"state": "MI",
"postal_code": "48310",
"telephone_number": "586-979-4700",
"fax_number": "586-979-9452"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KLANOW",
"first_name": "OTTO",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "D.D.S. M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-12-17",
"last_updated": "2008-12-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "2901011910",
"primary": false
},
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MI",
"license": "2901011910",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sterling Heights, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.