Kellerman Dental
Kellerman Dental is a healthcare organization registered as Dentist in Glen Carbon, IL, holding Type 2 (organization) NPI 1215102579 since 2008. The authorized official on file is Kevin Kellerman, Doctor.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1215102579 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Kellerman Dental |
| Practice address | 16 JUNCTION DR W STE 101, Glen Carbon, IL, 62034 |
| Phone | 6182883535 |
| Enumeration date | 2008-04-28 |
| Last updated in NPPES | 2008-04-28 |
Authorized official
| Name | Kevin Kellerman |
|---|---|
| Title | Doctor |
| Phone | 6182883535 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 122300000X | Dentist | Primary | 1004560 | IL |
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 108441 | Medicaid | IL | — |
Copy-ready billing details
Provider: Kellerman Dental NPI: 1215102579 Taxonomy: 122300000X (Dentist) Address: 16 JUNCTION DR W STE 101, Glen Carbon, IL, 62034
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1538543582 | Kellerman Dental Group, PC | Organization | Customized Equipment (DME) | Glen Carbon, IL |
| 1447944350 | Jessica Wen | Individual | Dentist | Glen Carbon, IL |
| 1033896865 | Jesse Snyder | Individual | Dentist | Glen Carbon, IL |
Verify this record
Cross-check NPI 1215102579 against the authoritative CMS record: view Kellerman Dental on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
Who is the authorized official for Kellerman Dental?
What is the NPI number for Kellerman Dental?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2008-04-28.