Individual provider Active NPI

John Howard Knight Jr., DDS

  • Dentist
  • Charlottesville, VA
National Provider Identifier
1215032206
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401410495 Issued in VA
Practice address
2202 N Berkshire Rd
Suite #203
Charlottesville, VA 22901-2761
Phone
(434) 293-9793
Fax
(434) 296-2090
NPI assigned
Sep 14, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401410495 VA Primary

Addresses

Primary practice location

2202 N Berkshire Rd
Suite #203
Charlottesville, VA 22901-2761

Mailing address

2202 N Berkshire Rd
Suite #203
Charlottesville, VA 22901-2761
Phone (434) 293-9793

Other identifiers 4

IdentifierTypeStateIssuer
10495OtherVAGUARDIAN
139544OtherVAANTHEM
10495OtherVADELTA DENTAL OF VA
1421573OtherVAUNITED CONCORDIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160606000633 VA Order and Referring Only - DentistPractitioner - Dentist 4385948033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401410495VAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Spring Creek Family Dentistry & Orthodontics Past Accepting new patients

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1215032206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2202 N BERKSHIRE RD",
            "address_2": "SUITE #203",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012761",
            "telephone_number": "434-293-9793",
            "fax_number": "434-296-2090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 N BERKSHIRE RD",
            "address_2": "SUITE #203",
            "city": "CHARLOTTESVILLE",
            "state": "VA",
            "postal_code": "229012761",
            "telephone_number": "434-293-9793",
            "fax_number": "434-296-2090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "JOHN",
        "middle_name": "HOWARD",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401410495",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "10495",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "139544",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL OF VA",
            "identifier": "10495",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1421573",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlottesville, VA

Sources for this page

Verify at the official NPI Registry.