Provider Demographics
NPI:1295225571
Name:KLAMER, JOHN DAVIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DAVIS
Last Name:KLAMER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1551 NW 38TH ST APT 202
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4571
Mailing Address - Country:US
Mailing Address - Phone:314-540-1117
Mailing Address - Fax:
Practice Address - Street 1:14790 N US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-8727
Practice Address - Country:US
Practice Address - Phone:816-532-8778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-13
Last Update Date:2018-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20180088671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice