Healthcare Provider Details

I. General information

NPI: 1245785898
Provider Name (Legal Business Name): JAMES H. KNIGHT, DDS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/23/2016
Last Update Date: 08/31/2022
Certification Date: 08/31/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 FLORAL AVE
FORT DODGE IA
50501-7721
US

IV. Provider business mailing address

1800 FLORAL AVE
FORT DODGE IA
50501-7721
US

V. Phone/Fax

Practice location:
  • Phone: 515-571-8251
  • Fax:
Mailing address:
  • Phone: 515-571-8251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number06995
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State

VIII. Authorized Official

Name: JAMES HENRY KNIGHT
Title or Position: PRESIDENT
Credential:
Phone: 515-573-8251