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KELLERMAN DENTAL
NPI 1215102579
Dentist in Glen Carbon, IL

Active since April 28, 2008
16 JUNCTION DR W STE 101, GLEN CARBON, IL 62034(618) 288-3535 Get Directions Write a Review

NPPES record last updated: April 28, 2008. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kellerman Dental NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELLERMAN DENTAL (NPI 1215102579) is a healthcare organization registered as a dentist in Glen Carbon, Illinois and active in the NPI registry since April 2008. The organization lists Kevin J Kellerman, Doctor, as its authorized official.

NPPES Registry Identity

NPI1215102579
Entity TypeOrganization
Primary Taxonomy122300000X
Legal Business NameKELLERMAN DENTAL
Location Address16 JUNCTION DR W STE 101Glen Carbon, IL 62034-2996
Mailing Address16 Junction Dr W Ste 101Glen Carbon, IL 62034-2996 · (618) 288-3535
Phone(618) 288-3535
Organization SubpartNo
Authorized OfficialKevin J KellermanDoctor · (618) 288-3535
Enumeration DateApril 28, 2008
✔ NPI 1215102579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in IL · 1004560
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
16 JUNCTION DR W STE 101, Glen Carbon, IL 62034
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Other Identifiers 1

Medicaid108441IL

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JESSE SNYDER DMD
Dentist
16 JUNCTION DR W STE 101
GLEN CARBON, IL 62034
Madison County (618) 228-3100
KELLERMAN DENTAL GROUP, PC
Durable Medical Equipment & Medical Supplies (Customized Equipment)
16 JUNCTION DR W STE 101
GLEN CARBON, IL 62034
Madison County (618) 288-3535

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kellerman Dental's NPI number?

The NPI number for Kellerman Dental is 1215102579. It was assigned to this organization in the NPPES registry on April 28, 2008.

Where is Kellerman Dental located?

Kellerman Dental is located at 16 Junction Dr W Ste 101, Glen Carbon, IL 62034. The listed phone number is (618) 288-3535.

What is Kellerman Dental's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Kellerman Dental was last updated on April 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.