Active NPI
Richard Russell Knubley, D.D.S.
- Periodontics
- Overland Park, KS
National Provider Identifier
1780689745
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 5115
- Practice address
- 5350 College Blvd
Ste 202
Overland Park, KS 66211-1633 - Phone
- (913) 327-0100
- Fax
- (913) 327-0102
- NPI assigned
- Jun 16, 2005
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 5115 | KS | Primary |
Addresses
Primary practice location
5350 College Blvd
Ste 202
Overland Park, KS 66211-1633
Mailing address
5350 College Blvd
Ste 202
Overland Park, KS 66211-1633
Phone (913) 327-0100
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
| License | State | Type | Specialty |
|---|---|---|---|
| 5115 | KS | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1780689745",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5350 COLLEGE BLVD",
"address_2": "STE 202",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111633",
"telephone_number": "913-327-0100",
"fax_number": "913-327-0102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5350 COLLEGE BLVD",
"address_2": "STE 202",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662111633",
"telephone_number": "913-327-0100",
"fax_number": "913-327-0102"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KNUBLEY",
"first_name": "RICHARD",
"middle_name": "RUSSELL",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "KS",
"license": "5115",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.