Active NPI
Kent Knoernschild, DMD, MS
- Prosthodontics
- Augusta, GA
National Provider Identifier
1306068192
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- DNF000429
- Practice address
- 1120 15TH Street, GC-4200
Augusta, GA 30912 - Phone
- (706) 721-8813
- NPI assigned
- May 3, 2007
- Last updated
- Feb 6, 2020
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 019020381 | IL | |
| Prosthodontics | 1223P0700X | DNF000429 | GA | Primary |
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
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- 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
- kknoernschild375775@direct-ucsfmedicalcenter.org
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"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
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.