Healthcare Provider Details

I. General information

NPI: 1114081312
Provider Name (Legal Business Name): MARIA A KARPOV DMD, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/21/2006
Last Update Date: 11/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 W 70TH ST #1J
NEW YORK NY
10023-3504
US

IV. Provider business mailing address

315 W 70TH ST #1J
NEW YORK NY
10023-3504
US

V. Phone/Fax

Practice location:
  • Phone: 212-245-4234
  • Fax: 212-514-4254
Mailing address:
  • Phone: 212-245-4234
  • Fax: 212-514-4254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number051209-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: