Christopher Gordon Klabo, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D13771 Issued in MN

Practice address

25477 Main St
Nisswa, MN 56468-5001

Phone

(189) 636-3302

NPI assigned

May 4, 2012

Last updated

Aug 17, 2020By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Luke Waln Dentistry, PC

  dba Nisswa Smiles

  • Dentist
  • Nisswa, MN
  • NPI 1427680040
  NPD
• Staples Smiles

  • Dentist
  • Staples, MN
  • NPI 1063172468
  NPD (past)
• Quirt Family Dentistry SC

  • Dentist
  • Schofield, WI
  • NPI 1205976776
  NPD (past)
• Quirt Family Dentistry, SC

  dba Quirt Family Dental - Schofield

  • General Practice Dentistry
  • Schofield, WI
  • NPI 1306112685
  NPD (past)

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

{
    "created_epoch": "1336089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597622400000",
    "number": "1871852392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25477 MAIN ST",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564685001",
            "telephone_number": "218-963-6330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25477 MAIN ST",
            "city": "NISSWA",
            "state": "MN",
            "postal_code": "564685001",
            "telephone_number": "189-636-3302"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLABO",
        "first_name": "CHRISTOPHER",
        "middle_name": "GORDON",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-05-04",
        "last_updated": "2020-08-17",
        "certification_date": "2020-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6976-15",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13771",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Vaughn Therapy Services LLC
• Craig Brian Johnson, DDS
• Derrek Johnson, D.C.
• Krista Johnson, O.T.
• Robert Buckner Jones Jr., M.D.
• Cathy Liane, MSLP
• Lighthouse Counseling, Cathy Liane, M.S.L.P.,LLC
• Luke Waln Dentistry, PC (Nisswa Smiles)
• Minnesota Holistic Clinic LLC (Minnesota Holistic Clinic)
• Angie Jean Monson, M.S. LMFT

• Dentist in Nisswa, MN
• Providers in Nisswa, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; 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.