Provider Demographics
NPI:1396255154
Name:FRED A. KNAYSI D.D.S., P.C.
Entity type:Organization
Organization Name:FRED A. KNAYSI D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:FRED
Authorized Official - Middle Name:A
Authorized Official - Last Name:KNAYSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:804-282-6005
Mailing Address - Street 1:8921 THREE CHOPT RD STE 304
Mailing Address - Street 2:
Mailing Address - City:HENRICO
Mailing Address - State:VA
Mailing Address - Zip Code:23229-4601
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8921 THREE CHOPT RD STE 304
Practice Address - Street 2:
Practice Address - City:HENRICO
Practice Address - State:VA
Practice Address - Zip Code:23229-4601
Practice Address - Country:US
Practice Address - Phone:804-282-6005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CENTRAL VIRGINIA DENTAL CARE PLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-10-06
Last Update Date:2017-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty