Healthcare Provider Details

I. General information

NPI: 1396282273
Provider Name (Legal Business Name): KAREN THOMAS DHA, MS HNFM, RDH BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/30/2017
Last Update Date: 04/06/2025
Certification Date: 04/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3004 MOUNT VERNON CHURCH RD
RALEIGH NC
27613-7406
US

IV. Provider business mailing address

3004 MOUNT VERNON CHURCH RD
RALEIGH NC
27613-7406
US

V. Phone/Fax

Practice location:
  • Phone: 919-961-2829
  • Fax:
Mailing address:
  • Phone: 919-961-2829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number5793
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: