MEDICARE: KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1811040298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.

Provider Business Mailing Address
First Line	:	2580 FOXFIELD RD STE 100
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60174-1411
Country	:	US
Telephone Number	:	630-377-7077
Fax Number	:

Provider Business Practice Location Address
First Line	:	2580 FOXFIELD RD STE 100
Second Line	:
City	:	ST CHARLES
State	:	IL
Zip	:	60174-1411
Country	:	US
Telephone Number	:	630-377-7077
Fax Number	:

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	MRS. LORI WHITE
Credential	:
Telephone Number	:	630-377-7077

Provider Enumeration Date	:	01/19/2007
Last Update Date	:	11/05/2015

Similar Medicare Providers

1760850291 — KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C.
Practice Location Address:

2580 FOXFIELD RD STE 100
ST CHARLES, IL
60174-1411

Practice Phone: 630-377-7077
Practice Fax:

1013295559 — MS. CONSUELA MARIE COLSTON LCSW
Practice Location Address:

2009 GRIFFIN ST
LAKE CHARLES, LA
70601-1411

Practice Phone: 337-377-8008
Practice Fax: 337-326-4443

1902249808 — COASTAL URGENT CARE OF LOUISIANA, LLC
Practice Location Address:

1411 ST. CHARLES ST.
HOUMA, LA
70360-3964

Practice Phone: 985-709-0136
Practice Fax: 985-709-0527

1154097996 — THIBODAUX REGIONAL URGENT CARE LLC
Practice Location Address:

1411 SAINT CHARLES ST
HOUMA, LA
70360-3964

Practice Phone: 985-709-0136
Practice Fax: 985-709-0527

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1003882150 — DR. KAJAL DASGUPTA M.D.
Practice Location Address:

2101 E JEFFERSON ST , KAISER PERMANENTE MEDICARE ENROLLMENT
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-2424
Practice Fax:

Directions to “KLOBERDANZ ORAL SURGERY AND DENTAL IMPLANTS P.C. ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.