Provider Demographics
NPI:1376808451
Name:KNIGHT, TAMEKA (DDS)
Entity Type:Individual
Prefix:
First Name:TAMEKA
Middle Name:
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 1:3451 GOODMAN RD E STE 122
Mailing Address - Street 2:
Mailing Address - City:SOUTHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:38672-9302
Mailing Address - Country:US
Mailing Address - Phone:662-892-8535
Mailing Address - Fax:
Practice Address - Street 1:3451 GOODMAN RD E STE 122
Practice Address - Street 2:
Practice Address - City:SOUTHAVEN
Practice Address - State:MS
Practice Address - Zip Code:38672-9302
Practice Address - Country:US
Practice Address - Phone:662-892-8535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-05
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX298021223D0001X
MS4347-22122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health