Provider Demographics
NPI:1316052491
Name:MCKNIGHT, CYRUS (DMD)
Entity type:Individual
Prefix:DR
First Name:CYRUS
Middle Name:
Last Name:MCKNIGHT
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 1:700 W HERMOSA DR
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-2732
Mailing Address - Country:US
Mailing Address - Phone:575-703-4101
Mailing Address - Fax:575-746-2953
Practice Address - Street 1:316 W SCHARBAUER ST
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-5132
Practice Address - Country:US
Practice Address - Phone:575-393-0323
Practice Address - Fax:575-393-0337
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD12451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMG0246Medicaid