Eric Jon Knutson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

32477 Issued in CA

Practice address

9712 Fair Oaks Blvd
#D
Fair Oaks, CA 95628-7032

Phone

(916) 966-0835

Fax

(916) 966-3921

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

Yes

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 CA

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

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333497600000",
    "number": "1962513408",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9712 FAIR OAKS BLVD",
            "address_2": "#D",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287032",
            "telephone_number": "916-966-0835",
            "fax_number": "916-966-3921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9712 FAIR OAKS BLVD",
            "address_2": "#D",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956287032",
            "telephone_number": "916-966-0835",
            "fax_number": "916-966-3921"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUTSON",
        "first_name": "ERIC",
        "middle_name": "JON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2012-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "32477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "680091765",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vladimir Kindruk, RPH
• Anita Marie King
• Loretta Lorraine Kirby
• Brieana Kline
• Kristine Kline, MA
• Serena Ko
• Susan Irene Koenig, LMFT
• Derek J. Kolander, DDS
• Julianna Elaine Krill, DPT
• Kristi Alexander D.D.S., Inc.

• General Practice Dentistry in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2012; 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.