Provider Demographics
NPI:1366606444
Name:KNIGHT, SHELBY LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:SHELBY
Middle Name:LYNN
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 1:135 W SLAUGHTER LN STE C
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78748-1727
Mailing Address - Country:US
Mailing Address - Phone:512-280-1117
Mailing Address - Fax:
Practice Address - Street 1:9801 ANDERSON MILL RD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78750-2274
Practice Address - Country:US
Practice Address - Phone:512-258-0670
Practice Address - Fax:512-258-0672
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2019-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX239951223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice