Provider Demographics
NPI:1174744460
Name:KNIGHT, VENSSA RIELS (DDS)
Entity type:Individual
Prefix:DR
First Name:VENSSA
Middle Name:RIELS
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:VENSSA
Other - Middle Name:
Other - Last Name:RIELS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:3080 PINEBROOK RD
Mailing Address - Street 2:SUITE #2000
Mailing Address - City:PARK CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84098-5422
Mailing Address - Country:US
Mailing Address - Phone:435-649-6688
Mailing Address - Fax:435-649-0654
Practice Address - Street 1:3080 PINEBROOK RD
Practice Address - Street 2:SUITE #2000
Practice Address - City:PARK CITY
Practice Address - State:UT
Practice Address - Zip Code:84098-5422
Practice Address - Country:US
Practice Address - Phone:435-649-6688
Practice Address - Fax:435-649-0654
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2019-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT3637309922332B00000X
UT363730122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies