Provider Demographics
NPI:1417842469
Name:KLEIMAN, KENNETH WILLIAM III (DDS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WILLIAM
Last Name:KLEIMAN
Suffix:III
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 1:1600 SUMMERPOINT DR
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MO
Mailing Address - Zip Code:63026-6930
Mailing Address - Country:US
Mailing Address - Phone:314-650-8136
Mailing Address - Fax:
Practice Address - Street 1:14377 WOODLAKE DR STE 113
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-5735
Practice Address - Country:US
Practice Address - Phone:314-576-1777
Practice Address - Fax:314-576-4584
Is Sole Proprietor?:No
Enumeration Date:2025-06-10
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20250202361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice