Provider Demographics
NPI:1598443228
Name:KNIGHTON, JARED (DMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:
Last Name:KNIGHTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1020
Mailing Address - Street 2:
Mailing Address - City:WINNISQUAM
Mailing Address - State:NH
Mailing Address - Zip Code:03289-1020
Mailing Address - Country:US
Mailing Address - Phone:603-528-1212
Mailing Address - Fax:
Practice Address - Street 1:944 LACONIA RD
Practice Address - Street 2:
Practice Address - City:WINNISQUAM
Practice Address - State:NH
Practice Address - Zip Code:03289
Practice Address - Country:US
Practice Address - Phone:603-528-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH04848122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice