Provider Demographics
NPI:1972170215
Name:KNAPKE, SCOTT J (DDS)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:J
Last Name:KNAPKE
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 1:3854 SHADOWSTONE WAY
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43221-5933
Mailing Address - Country:US
Mailing Address - Phone:740-506-3201
Mailing Address - Fax:
Practice Address - Street 1:403 E KEMPER RD
Practice Address - Street 2:
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3228
Practice Address - Country:US
Practice Address - Phone:513-729-7245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-07
Last Update Date:2021-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0264901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice