Kaitlin Knutson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

1001604-15 Issued in WI

Practice address

501 Lucas LN
Ellsworth, WI 54011-2800

Phone

(715) 273-3700

NPI assigned

Jun 18, 2017

Last updated

Jun 14, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Knutson Family Dental

  • Dental Clinic/Center
  • Ellsworth, WI
  • NPI 1841871845
  NPD Authorized official
• Blue Diamond Family Dental SC

  • Dentist
  • Bloomer, WI
  • NPI 1245433580
  NPD (past)
• Shaw Family Dental SC

  • General Practice Dentistry
  • Ellsworth, WI
  • NPI 1396162020
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1497744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623628800000",
    "number": "1104356542",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 310",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540110310",
            "telephone_number": "715-273-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 LUCAS LN",
            "city": "ELLSWORTH",
            "state": "WI",
            "postal_code": "540112800",
            "telephone_number": "715-273-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "KAITLIN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-18",
        "last_updated": "2021-06-14",
        "certification_date": "2021-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "1001604-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gary S Holden, CADCIII
• Kristie A Ineichen, PSYD LP
• Samantha K Johnson, DC
• Carrie Lynn Kern
• Knutson Family Dental
• Lindsey Kocina
• Amy Alissa Kohls, COTA
• Kollbaum Chiropractic Limited
• Kyle Timothy Kollbaum, D.C.
• Kjrsten Lokker

• Dentist in Ellsworth, WI
• Providers in Ellsworth, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.