MEDICARE: DR. DAVID ARNOLD KNOP II D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	12010499A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1496367	OTHER	IN	UNITED CONCORDIA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	43000250A	OTHER	IN	IV SEDATION

General Provider Information

NPI Number	:	1912121088
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID ARNOLD KNOP II D.D.S.

Provider Business Mailing Address
First Line	:	2122 SCOTT ST
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2932
Country	:	US
Telephone Number	:	765-447-2456
Fax Number	:	765-449-1356

Provider Business Practice Location Address
First Line	:	2122 SCOTT ST
Second Line	:
City	:	LAFAYETTE
State	:	IN
Zip	:	47904-2932
Country	:	US
Telephone Number	:	765-447-2456
Fax Number	:	765-449-1356

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	03/07/2023

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