Provider Demographics
NPI:1770965832
Name:MCKNIGHT, MITCHELL (DDS, MD)
Entity type:Individual
Prefix:DR
First Name:MITCHELL
Middle Name:
Last Name:MCKNIGHT
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8315 WALNUT HILL LN STE 225
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75231-4297
Mailing Address - Country:US
Mailing Address - Phone:214-396-9946
Mailing Address - Fax:
Practice Address - Street 1:8315 WALNUT HILL LN STE 225
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75231-4297
Practice Address - Country:US
Practice Address - Phone:214-396-9946
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-25
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX312501223S0112X
NY0593971223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery