Individual provider Active NPI

Michael Alan Knight Jr., DMD

  • General Practice Dentistry
  • Eastman, GA
National Provider Identifier
1417443789
Registry record updated Oct 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN015700 Issued in GA
Practice address
5106 Oak St
Eastman, GA 31023
Phone
(478) 468-4959
Fax
(478) 268-4959
NPI assigned
Jul 10, 2018
Last updated
Oct 19, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN015700 GA Primary

Addresses

Primary practice location

5106 Oak St
Eastman, GA 31023

Mailing address

5106 Oak St
Eastman, GA 31023
Phone (478) 468-4959

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

State licenses

LicenseStateTypeSpecialty
DN015700GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1531180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1417443789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5106 OAK ST",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "31023",
            "telephone_number": "478-468-4959",
            "fax_number": "478-268-4959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5106 OAK ST",
            "city": "EASTMAN",
            "state": "GA",
            "postal_code": "31023",
            "telephone_number": "478-468-4959",
            "fax_number": "478-268-4959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNIGHT",
        "first_name": "MICHAEL",
        "middle_name": "ALAN",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-10",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN015700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eastman, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 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.

Verify at the official NPI Registry.