Healthcare Provider Details

I. General information

NPI: 1346572625
Provider Name (Legal Business Name): KAREN MEJIAS DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2010
Last Update Date: 02/25/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26827 FOGGY CREEK RD SUITE 103
WESLEY CHAPEL FL
33544-6768
US

IV. Provider business mailing address

26827 FOGGY CREEK RD SUITE 103
WESLEY CHAPEL FL
33544-6768
US

V. Phone/Fax

Practice location:
  • Phone: 813-994-4777
  • Fax:
Mailing address:
  • Phone: 813-994-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN-10105
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number18930
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: