DEREK R. KAELIN D.D.S, LLC (NPI# 1285939157) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285939157 |
| Entity Type | Organization |
| Organization Name | DEREK R. KAELIN D.D.S, LLC |
| Other Organization Name | JAMES RIVER DENTAL |
| Practice Address |
4205 S Nature Center Way Springfield MO 65804-4921 |
| Practice Telephone | 4178622468 |
| Mailing Telephone | 4178622468 |
| Enumeration Date | 2011-01-24 |
| Last Update Date | 2011-01-24 |
| Authorized Official Name | DR. DEREK R KAELIN (DENTIST OWNER) |
| Authorized Official Telephone | 4178622468 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
2003017125 | MO | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| James River Dental | Doing Business As Name - Organization |
| Street Address |
4205 S NATURE CENTER WAY |
| City | SPRINGFIELD |
| State | MO |
| Zip Code | 65804-4921 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790393049 | Kathy Forson | Nurse Practitioner | 1235 E. Cherokee St., Springfield, MO 65804 | 2020-07-22 |
| 1306498779 | Anne B Summers, LLC | Social Worker | 1310 E. Kingsley St., Ste C, Springfield, MO 65804 | 2019-07-15 |
| 1790241800 | Margaret Mary Hart | Social Worker | 1845 S Rogers Ave, Springfield, MO 65804 | 2019-02-13 |
| 1598254666 | Casey Carr | Optometrist | 1229 E Seminole St Ste 110, Springfield, MO 65804 | 2018-05-04 |
| 1124520697 | Shelby D White | Behavioral Analyst | 1300 E. Bradford Parkway, Springfield, MO 65804 | 2018-03-01 |
| 1316448343 | Karl Lynham | Massage Therapist | 1200 E Woodhurst Dr R300, Springfield, MO 65804 | 2018-02-25 |
| 1699273763 | Leah Wilson | Counselor | 1322 E Woodgate, Springfield, MO 65804 | 2018-01-24 |
| 1295242626 | Matthew Crisp | Physical Therapist | 3252 E Independence St, Springfield, MO 65804 | 2018-01-08 |
| 1518491042 | Crystal Spangler | Dietitian, Registered | 1965 S Fremont Ave Ste 220, Springfield, MO 65804 | 2017-04-11 |
| 1588012033 | Jeffrey Williams | Pharmacist | 1235 E. Cherokee, Springfield, MO 65804 | 2016-05-25 |
| Find all providers in zip 65804 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568092377 | Center for Dental Sleep Medicine, PC | Clinic/Center | 1795 Main St Ste 108, Springfield, MA 01103-1078 | 2020-01-21 |
| 1689228140 | Dr Dental of Massachusetts PC | Clinic/Center | 1101 Boston Road, Springfield, MA 01119 | 2019-08-01 |
| 1275094864 | Itooth Family Dentistry, LLC | Clinic/Center | 3211 E Battlefield St Ste 100, Springfield, MO 65804-4071 | 2019-03-27 |
| 1164918868 | Noble Family Dental PC | Clinic/Center | 665 Boston Rd, Springfield, MA 01119-1303 | 2018-07-05 |
| 1316430952 | Peterson Dental Care LLC | Clinic/Center | 2501 W Iles Ave Ste A, Springfield, IL 62704-6482 | 2018-06-08 |
| 1447765029 | Dental 32, L.L.C. | Clinic/Center | 2142 S Brentwood Blvd, Springfield, MO 65804-2539 | 2017-12-05 |
| 1922435148 | Kelly Dental LLC | Clinic/Center | 1655 S. Enterprise Ave Ste. A-3, Springfield, MO 65804 | 2013-10-02 |
| 1184986077 | All About Smiles Lc | Clinic/Center | 1717 E Cherokee St, Suite 104, Springfield, MO 65804-2335 | 2012-06-15 |
| 1295030203 | Derek R. Kaelin, D.d.s, LLC | Clinic/Center | 2105 W Kearney St Ste A, Springfield, MO 65803-1666 | 2011-01-21 |
| 1477867612 | Springfield Community Dental Clinic | Clinic/Center | 1 Armory Sq, Springfield, MA 01105-1700 | 2010-07-29 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 65804 |
Please comment or provide details below to improve the information on DEREK R. KAELIN D.D.S, LLC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.