Active NPI
Andrew Robert Knofczynski, DDS, MS
- Dentist
- Portsmouth, VA
National Provider Identifier
1679915128
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DEN 00202053
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-2759
- NPI assigned
- Jul 25, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DEN 00202053 | CO | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Phone (757) 953-7550
Other practice location 1
Naval Health Clinic New England
43 Smith Road
Newport, RI 02841-1006
Phone (401) 841-3819
Other practice location 2
554 Keily Street
Jacksonville, FL 32212
Phone (757) 953-7550
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | andrew.r.knofczynski.mil@health.mil | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210713003377 | CO | Order and Referring Only - Dentist | 3678975646 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DEN 00202053 | CO | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1374710400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669852800000",
"number": "1679915128",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-7550",
"fax_number": "757-953-7560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-2759"
}
],
"practiceLocations": [
{
"address_1": "Naval Health Clinic New England",
"address_2": "43 Smith Road",
"address_purpose": "LOCATION",
"city": "Newport",
"state": "RI",
"postal_code": "028411006",
"country_code": "US",
"telephone_number": "401-841-3819",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "554 Keily Street",
"address_purpose": "LOCATION",
"city": "Jacksonville",
"state": "FL",
"postal_code": "32212",
"country_code": "US",
"telephone_number": "757-953-7550",
"fax_number": "757-953-7560",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "KNOFCZYNSKI",
"first_name": "ANDREW",
"middle_name": "ROBERT",
"name_prefix": "Dr.",
"credential": "DDS, MS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-25",
"last_updated": "2022-12-01",
"certification_date": "2022-11-29",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "DEN 00202053",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "andrew.r.knofczynski.mil@health.mil",
"affiliation": "N",
"endpointDescription": "Email",
"use": "DIRECT",
"useDescription": "Direct",
"address_1": "620 John Paul Jones Cir",
"city": "Portsmouth",
"state": "VA",
"country_code": "US",
"postal_code": "237082111",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.