Provider Demographics
NPI:1235353459
Name:KNIGHT, KAREN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:A
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4106 MARATHON BLVD
Mailing Address - Street 2:SUITE A
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3745
Mailing Address - Country:US
Mailing Address - Phone:512-451-1222
Mailing Address - Fax:
Practice Address - Street 1:4106 MARATHON BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3745
Practice Address - Country:US
Practice Address - Phone:512-451-1222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX158031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX15803OtherSTATE DENTAL LICENCE