Jennifer Knickerbocker, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D011775 Issued in AZ

Practice address

2334 N 11TH St
Phoenix, AZ 85006-1635

Phone

(916) 267-8076

NPI assigned

May 25, 2023

Last updated

May 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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": "1684972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684972800000",
    "number": "1922790179",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2334 N 11TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061635",
            "telephone_number": "916-267-8076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2334 N 11TH ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850061635",
            "telephone_number": "916-267-8076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNICKERBOCKER",
        "first_name": "JENNIFER",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-05-25",
        "last_updated": "2023-05-25",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011775",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie E Knecht, PHARMD
• Jolene Knee, PHYSICAL THERAPIST
• James Kneller, MD
• Monique Marie Knepper, LPN
• Laurynn Knerr, RN IBCLC
• Kerry Knievel, D.O.
• Knight Anesthesia LLC
• Amy Nicole Knight, COTA/L
• Breanna Alexis Knight
• Carolyn Knight, RN

• General Practice Dentistry in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2023; 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.