Alyse Marie Knuth, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1002167-15 Issued in WI

Practice address

Gruber Road
Fort Bragg, NC 28310-0001

Phone

(414) 388-2324

NPI assigned

Mar 22, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Alyse Marie Gooderham Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1553212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718668800000",
    "number": "1871053165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7035 BLAIR RD NW APT 113",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200121962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRUBER ROAD",
            "city": "FORT BRAGG",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "414-388-2324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTH",
        "first_name": "ALYSE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-03-22",
        "last_updated": "2024-06-18",
        "certification_date": "2024-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1002167-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALYSE",
            "last_name": "GOODERHAM",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Dawn-Marie Knight, O.D., F.A.A.O.
• John G. Knight Jr., M.D.
• Ryan Melink Knight, MD
• Lorraine Nicole Knoll, OTR/L
• Lee Andrew Knox Jr., DDS
• Chong Ko, DPT
• Susan Oakes Koagel, DMD
• Mark Ross Kobialka, PA
• James L Koehler Jr., DMD
• Chad A Koenig

• General Practice Dentistry in Fort Bragg, NC
• Providers in Fort Bragg, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2024; 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.