Provider Demographics
NPI:1669951695
Name:KNEFELKAMP, SARAH LYNN (DDS)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LYNN
Last Name:KNEFELKAMP
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:LYNN
Other - Last Name:KNEFELKAMP
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7750 W 200 S
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:IN
Mailing Address - Zip Code:46571-9436
Mailing Address - Country:US
Mailing Address - Phone:260-768-7918
Mailing Address - Fax:260-768-7983
Practice Address - Street 1:7750 W 200 S
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:IN
Practice Address - Zip Code:46571-9436
Practice Address - Country:US
Practice Address - Phone:260-768-7918
Practice Address - Fax:260-768-7983
Is Sole Proprietor?:No
Enumeration Date:2018-08-10
Last Update Date:2018-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12012981A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist