Provider Demographics
NPI:1255957585
Name:KNAPKE, ASHLEY RENEE GABREK (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:RENEE GABREK
Last Name:KNAPKE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11219 MALLORY CT
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:IN
Mailing Address - Zip Code:46783-8602
Mailing Address - Country:US
Mailing Address - Phone:260-452-4233
Mailing Address - Fax:
Practice Address - Street 1:9121 ILLINOIS RD
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-5753
Practice Address - Country:US
Practice Address - Phone:260-434-0099
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-23
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013392A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice