Matthew Richard Knutson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

M969 Issued in SD

Practice address

1714 E Cherry St
Vermillion, SD 57069

Phone

(605) 624-6291

Fax

(605) 624-9488

NPI assigned

Apr 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SD

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Knutson Familty Dentistry LLP

  • Dentist
  • Vermillion, SD
  • NPI 1134313091
  NPD (past)

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710008388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1714 E CHERRY ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "57069",
            "telephone_number": "605-624-6291",
            "fax_number": "605-624-9488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1714 E CHERRY ST",
            "city": "VERMILLION",
            "state": "SD",
            "postal_code": "57069",
            "telephone_number": "605-624-6291",
            "fax_number": "605-624-9488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "MATTHEW",
        "middle_name": "RICHARD",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SD",
            "license": "M969",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7809990",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Phillip Jundt, M.D.
• Dena Marie Jundt, M.D.
• Kathryn Therese Kassin, PA
• Shelby Keeton, DDS
• Knutson Familty Dentistry LLP
• Richard Leonard Knutson, DDS
• Kopf Dental Group
• Blake Kopf, DDS
• Solveig Sperati Korte
• Matthew D Krell, MD

• General Practice Dentistry in Vermillion, SD
• Providers in Vermillion, SD by specialty
• General Practice Dentistry in South Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.