Healthcare Provider Details

I. General information

NPI: 1932029691
Provider Name (Legal Business Name): RYAN SHAKER KARJO DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2026
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3760 S DORT HWY
FLINT MI
48507-2051
US

IV. Provider business mailing address

45869 LONE PINE LN
MACOMB MI
48044-6058
US

V. Phone/Fax

Practice location:
  • Phone: 810-820-7766
  • Fax:
Mailing address:
  • Phone: 586-477-8234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603202
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: