Provider Demographics
NPI:1205113859
Name:KNIGHT, RICHARD (DDS)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 DOUGLAS BLVD STE 130
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-3993
Mailing Address - Country:US
Mailing Address - Phone:916-782-2278
Mailing Address - Fax:
Practice Address - Street 1:2520 DOUGLAS BLVD STE 130
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3993
Practice Address - Country:US
Practice Address - Phone:916-782-2278
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501521223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry