Healthcare Provider Details

I. General information

NPI: 1801682380
Provider Name (Legal Business Name): LANDON KLEINGARTNER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2025
Last Update Date: 07/28/2025
Certification Date: 07/28/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 W WISE RD
SCHAUMBURG IL
60193-3821
US

IV. Provider business mailing address

2697 S EMBERS LN
ARLINGTON HEIGHTS IL
60005-4672
US

V. Phone/Fax

Practice location:
  • Phone: 701-426-1047
  • Fax:
Mailing address:
  • Phone: 701-426-1047
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number019.036352
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: