Healthcare Provider Details

I. General information

NPI: 1417914664
Provider Name (Legal Business Name): JENNIFER HELEN KARANIAN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/28/2006
Last Update Date: 07/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1134 VINE ST
PASO ROBLES CA
93446-2561
US

IV. Provider business mailing address

1134 VINE ST
PASO ROBLES CA
93446-2561
US

V. Phone/Fax

Practice location:
  • Phone: 805-238-1441
  • Fax:
Mailing address:
  • Phone: 805-238-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number59025
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: