Healthcare Provider Details

I. General information

NPI: 1972438224
Provider Name (Legal Business Name): SAFARI PEDIATRIC DENTISTRY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 06/17/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3337 SHORES RD SUITE 102
MURFREESBORO TN
37128
US

IV. Provider business mailing address

3337 SHORES RD SUITE 102
MURFREESBORO TN
37128
US

V. Phone/Fax

Practice location:
  • Phone: 925-451-2441
  • Fax:
Mailing address:
  • Phone: 925-451-2441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. PATRICK KEVIN KNOELL
Title or Position: OWNER
Credential: DDS
Phone: 925-451-2441