Healthcare Provider Details

I. General information

NPI: 1245729557
Provider Name (Legal Business Name): KAREN Y JO DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2018
Last Update Date: 02/07/2025
Certification Date: 02/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10801 LOCKWOOD DR STE 240
SILVER SPRING MD
20901-1563
US

IV. Provider business mailing address

2115 HENSON NORRIS ST
ROCKVILLE MD
20850-6578
US

V. Phone/Fax

Practice location:
  • Phone: 301-681-4812
  • Fax:
Mailing address:
  • Phone: 240-449-7419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number16867
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: