Kent Knoernschild, DMD, MS – Prosthodontics

Key facts

NPI: 1306068192
Entity type: Individual (NPI type 1)
Primary specialty: Prosthodontics 1223P0700X
License: DNF000429 (GA)
Practice address: 1120 15TH Street, GC-4200
Augusta, GA 30912
Phone: (706) 721-8813
NPI assigned: May 3, 2007
Sex: Male
Sole proprietor: No

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.

Board of Trustees of the University of Illinois Dentist · Chicago, IL · NPI 1992873921

NPD (past) PROSTHODONTICS

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No
Credentials: Master of Science

State licenses

License	State	Type	Specialty
DNF000429	GA	MD	Prosthodontist
019020381	IL	MD	Prosthodontist

Practice roles

Organization	Specialty	Status	New patients
Board of Trustees of the University of Illinois	Prosthodontics	Past	Accepting new patients

Interoperability endpoints

Direct secure messaging: kknoernschild375775@direct-ucsfmedicalcenter.org

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Prosthodontics	1223P0700X	019020381	IL
Prosthodontics	1223P0700X	DNF000429	GA	Yes

Addresses

Primary practice location

1120 15TH Street, GC-4200
Augusta, GA 30912

Mailing address

1120 15TH Street, GC-4200
Augusta, GA 30912
Phone (706) 721-8813

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Feb 6, 2020.

{
    "created_epoch": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580947200000",
    "number": "1306068192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET, GC-4200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-8813",
            "fax_number": "312-355-3864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH STREET, GC-4200",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "30912",
            "telephone_number": "706-721-8813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNOERNSCHILD",
        "first_name": "KENT",
        "credential": "DMD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-03",
        "last_updated": "2020-02-06",
        "certification_date": "2020-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "IL",
            "license": "019020381",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "GA",
            "license": "DNF000429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

All providers in Augusta, GA · Prosthodontics in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 6, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.