OrganizationActive
Derek R. Kaelin, D.D.S, LLC
NPI 1295030203 · Dental Clinic/Center · Springfield, MO
Provider details
- NPI number
- 1295030203
- Entity type
- Organization
- Primary specialty
- Dental Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- Derek Kaelin, Dentist / Owner(417) 862-2468
- License
- 2003017125 (MO)
Specialties & taxonomies
Ambulatory Health Care Facilities
Profile Score
Detailed profile(82/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
15 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2105 W Kearney St Ste a
Springfield, MO 65803-1666
Phone: (417) 862-2468
Fax: (417) 863-6775
Street-level locationGet directions
Mailing address
2105 W Kearney St Ste a
Springfield, MO 65803-1666
Other names (DBA / former)
- Doing business as
- Northside Dental Clinic
Registry dates
- Enumerated
- 2011-01-21
- Last updated
- 2011-01-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.