1. Home
  2. Directory
  3. Missouri
  4. Springfield
  5. Clinic Center
  6. NPI Profile

NORTHSIDE DENTAL CLINIC
NPI 1295030203
Clinic/Center - Dental in Springfield, MO

Active since January 21, 2011
2105 W KEARNEY ST STE A, SPRINGFIELD, MO 65803(417) 862-2468(417) 863-6775 Get Directions Write a Review

NPPES record last updated: January 21, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Northside Dental Clinic NPPES

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

NORTHSIDE DENTAL CLINIC (NPI 1295030203) is a healthcare organization registered as a dental in Springfield, Missouri and active in the NPI registry since January 2011. The organization lists Derek R Kaelin, Dentist / Owner, as its authorized official.

NPPES Registry Identity

NPI1295030203
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameDEREK R. KAELIN, D.D.S, LLC
Location Address2105 W KEARNEY ST STE ASpringfield, MO 65803-1666
Mailing Address2105 W Kearney St Ste ASpringfield, MO 65803-1666 · (417) 862-2468 · Fax (417) 863-6775
Phone(417) 862-2468
Fax(417) 863-6775
Organization SubpartNo
Authorized OfficialDerek R KaelinDentist / Owner · (417) 862-2468
Enumeration DateJanuary 21, 2011
✔ NPI 1295030203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in MO · 2003017125
2105 W KEARNEY ST STE A, Springfield, MO 65803
Open in Google Maps ↗

Other Names 1

Doing Business AsNorthside Dental Clinic

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and more.Insurance ›

Other Providers at the Same Location NPPES 4

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

DR. VLADIMIR A GRISHIN DDS
Dentist
2105 W KEARNEY ST STE A
SPRINGFIELD, MO 65803
Greene County (417) 862-2468
ASHTON ELIZABETH STEWART DMD
Dentist
2105 W KEARNEY ST STE A
SPRINGFIELD, MO 65803
Greene County (417) 862-2468
ASHLEY DAWN MEYER D.D.S.
Dentist (General Practice)
2105 W KEARNEY ST STE A
SPRINGFIELD, MO 65803
Greene County (417) 862-2468
DR. BRADY HULL DMD
Dentist (General Practice)
2105 W KEARNEY ST STE A
SPRINGFIELD, MO 65803
Greene County (417) 862-2468

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 Derek R. Kaelin, D.D.S, LLC's NPI number?

The NPI number for Derek R. Kaelin, D.D.S, LLC is 1295030203. It was assigned to this organization in the NPPES registry on January 21, 2011. The provider is doing business as Northside Dental Clinic.

Where is Derek R. Kaelin, D.D.S, LLC located?

Derek R. Kaelin, D.D.S, LLC is located at 2105 W Kearney St Ste A, Springfield, MO 65803. The listed phone number is (417) 862-2468.

What is Derek R. Kaelin, D.D.S, LLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

What insurance does Derek R. Kaelin, D.D.S, LLC accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 2 other insurers list Derek R. Kaelin, D.D.S, LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Derek R. Kaelin, D.D.S, LLC was last updated on January 21, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 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.