Kelli Jean Brunk Blank, D.M.D.

Dentist · Vandalia, IL

Individual Active NPI

NPI number 1730475617

Practice location

607 W Orchard St
Vandalia, IL 62471-1234
Phone
(618) 283-2929
Fax
(618) 283-2113

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NPI record

NPI
1730475617
Entity type
Individual (Type 1)
Enumeration date
June 20, 2011
Last updated
August 17, 2015
Sole proprietor
Yes

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Dentist Primary 122300000X 019028666 IL

About Dr. Blank

Kelli Jean Brunk Blank, D.M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy Dentist (code 122300000X). The practice location is 607 W Orchard St, Vandalia, IL 62471-1234. The NPI number 1730475617 was assigned on June 20, 2011 and the record was last updated on August 17, 2015.

Dr. Blank lists a license in the registry: #019028666 (IL) for Dentist. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Kelli Jean Brunk Blank, D.M.D.?

The NPI number is 1730475617.

What is the phone number of Dr. Blank?

The phone number listed for the practice location is (618) 283-2929.

Where is Dr. Blank located?

607 W Orchard St, Vandalia, IL 62471-1234.

What is the taxonomy code for Dr. Blank?

The primary taxonomy code is 122300000X – Dentist.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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