Michael C Knierim, DDS

Individual provider Active NPI General Practice Dentistry · Pleasanton, KS

NPI 1407899115 · NPPES record last updated Jul 13, 2026

Key facts

NPI
1407899115
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5805 (KS)
Practice address
805 Main
Pleasanton, KS 66075
Phone
(913) 352-8503
Fax
(913) 352-8440
NPI assigned
Jun 13, 2006
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5805KSMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5805 KS Yes

Addresses

Primary practice location

805 Main
Pleasanton, KS 66075

Mailing address

PO Box 467
805 Main
Pleasanton, KS 66075
Phone (913) 352-8503

Other identifiers

IdentifierTypeStateIssuer
1005548OtherKSHEALTH GUARD TILLE 21
116665OtherKSBCBS OF KS

Other providers in Pleasanton, KS

All providers in Pleasanton, KS · General Practice Dentistry in Kansas

Sources for this page

Verify at the official NPI Registry.