NPIMap

Organization Active NPI

Mark a Knollman DDS PA

  • Dentist
  • Asheville, NC
National Provider Identifier
1780750703
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5720 Issued in NC
Legal business name
MARK A KNOLLMAN DDS PA
Practice address
600 B Centrepark Drive
Asheville, NC 28805
Phone
(828) 254-5677
Fax
(828) 254-1468
NPI assigned
Nov 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mrs. Angela Dawn Hicks
Title
Office Manager
Phone
(828) 254-5677

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 5720 NC Primary

Addresses

Primary practice location

600 B Centrepark Drive
Asheville, NC 28805

Mailing address

600 B Centrepark Drive
Asheville, NC 28805
Phone (828) 254-5677

Other identifiers 1

IdentifierTypeStateIssuer
8995064MedicaidNC

National Provider Directory

National Provider Directory

Locations

600B Centrepark Dr
Asheville, NC 28805
Phone (828) 254-5677

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1780750703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 B CENTREPARK DRIVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28805",
            "telephone_number": "828-254-5677",
            "fax_number": "828-254-1468"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 B CENTREPARK DRIVE",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "28805",
            "telephone_number": "828-254-5677",
            "fax_number": "828-254-1468"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A KNOLLMAN DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "DAWN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "828-254-5677",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "5720",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8995064",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Asheville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.