Provider Demographics
NPI:1134526247
Name:KNIGHT, MELINDA
Entity type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:
Last Name:KNIGHT
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:MELINDA
Other - Middle Name:
Other - Last Name:KNIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:717 NE 36TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73105-7203
Mailing Address - Country:US
Mailing Address - Phone:405-524-7214
Mailing Address - Fax:405-524-7217
Practice Address - Street 1:717 NE 36TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73105-7203
Practice Address - Country:US
Practice Address - Phone:405-524-7214
Practice Address - Fax:405-524-7217
Is Sole Proprietor?:No
Enumeration Date:2014-12-04
Last Update Date:2014-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6631122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist