Active NPI
Donald C. Kellner DDS-Aurora PC
- Dentist
- Aurora, IL
National Provider Identifier
1972878197
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019017632
- Legal business name
- DONALD C. KELLNER DDS-AURORA PC
- Practice address
- 143 South Lincoln Ave
Suite a
Aurora, IL 60505 - Phone
- (630) 859-3151
- Fax
- (630) 851-0105
- NPI assigned
- Mar 21, 2012
- Last updated
- Mar 21, 2012
- Organization subpart
- Yes
- Parent organization
- DONALD C. KELLNER DDS-AURORA PC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Donald C. Kellner, DDS
- Title
- Owner/Dentist
- Phone
- (630) 859-3151
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 019028094 | IL | |
| Dentist | 122300000X | 019024905 | IL | |
| Dentist | 122300000X | 019017632 | IL | Primary |
Addresses
Primary practice location
143 South Lincoln Ave
Suite a
Aurora, IL 60505
Mailing address
143 South Lincoln Ave
Suite a
Aurora, IL 60505
Phone (630) 859-3151
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019017632 | Medicaid | IL |
National Provider Directory
National Provider Directory- Part of
- Donald C Kellner DDS-Aurora PC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1332288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1332288000000",
"number": "1972878197",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "143 SOUTH LINCOLN AVE",
"address_2": "SUITE A",
"city": "AURORA",
"state": "IL",
"postal_code": "60505",
"telephone_number": "630-859-3151",
"fax_number": "630-859-0105"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "143 SOUTH LINCOLN AVE",
"address_2": "SUITE A",
"city": "AURORA",
"state": "IL",
"postal_code": "60505",
"telephone_number": "630-859-3151",
"fax_number": "630-851-0105"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "DONALD C. KELLNER DDS-AURORA PC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "DONALD C. KELLNER DDS-AURORA PC",
"enumeration_date": "2012-03-21",
"last_updated": "2012-03-21",
"status": "A",
"authorized_official_last_name": "KELLNER",
"authorized_official_first_name": "DONALD",
"authorized_official_middle_name": "C.",
"authorized_official_title_or_position": "OWNER/DENTIST",
"authorized_official_telephone_number": "630-859-3151",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "DDS"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019028094",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019024905",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "IL",
"license": "019017632",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "019017632",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Aurora, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.