KLOCKOW PC NPI 1861861254

NPI Information

  • NPI: 1861861254
  • Provider Name: KLOCKOW PC
  • Classification: Clinic/Center - 261QD0000X
  • Specialization: Dental
  • Entity Type: Organization
  • Address: 118 S VAN RENSSELAER ST
    RENSSELAER, IN
    ZIP 47978
  • Phone: (219) 869-1097

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NPI Details

KLOCKOW PC is a dental clinic center in Rensselaer, IN. KLOCKOW PC NPI is 1861861254. The provider is registered as an organization entity type.

The provider's business location address is:

118 S VAN RENSSELAER ST
RENSSELAER, IN
ZIP 47978-815
Phone: (219) 869-1097
Fax: (219) 267-1729

The provider's authorized official is Raymond Gordon Klockow .
The authorized official title is President and has the following contact phone number (219) 869-1097.

The enumeration date for this NPI number is 9/16/2015 and was last updated on 9/16/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QD0000XClinic/CenterDental54000437AINDIANAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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