Individual provider Active NPI

Tameka Knight, D.D.S.

  • Dentist
  • Southaven, MS
National Provider Identifier
1376808451
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4347-22 Issued in MS
Practice address
3451 Goodman Rd E Ste 122
Southaven, MS 38672-9302
Phone
(662) 892-8535
NPI assigned
Jul 5, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 29802 TX
Dentist 122300000X 4347-22 MS Primary

Addresses

Primary practice location

3451 Goodman Rd E Ste 122
Southaven, MS 38672-9302

Mailing address

3451 Goodman Rd E Ste 122
Southaven, MS 38672-9302
Phone (662) 892-8535

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20150730012798 TX Order and Referring Only - DentistPractitioner - Dentist 5799099099

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4347-22MSMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Keep on Smiling Pediatric and General Dentistry PLLC Dentist CurrentSince Apr 9, 2023 Accepting new patients
Atascocita Modern Dentistry and Orthodontics, PC Past Accepting new patients

Locations

3451 Goodman Rd E
Ste 122
Southaven, MS 38672
Phone (662) 892-8535

Organizations & group practices 2

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": "1341446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1376808451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 122",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729302",
            "telephone_number": "662-892-8535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3451 GOODMAN RD E STE 122",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386729302",
            "telephone_number": "662-892-8535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "TAMEKA",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-07-05",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "TX",
            "license": "29802",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "4347-22",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southaven, MS

Sources for this page

Verify at the official NPI Registry.