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General NPI Number Information
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NPI Number | 1275028524
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Entity Type | Individual
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Provider Name | LJILJANA KARAN DMD
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Gender | Female
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Dates
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Enumeration Date | 06/28/2018
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Last Update Date | 05/20/2019
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Provider Practice Location Address
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Address Line | 2258 W ROOSEVELT BLVD STE A
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City | MONROE
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State | NC
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Zip | 28110-3090
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Country | US
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Telephone | 704-291-7100
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Fax |
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Provider Business Mailing Address
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Address Line | 1851 MACGREGOR DOWNS RD
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City | GREENVILLE
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State | NC
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Zip | 27834-5925
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Country | US
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Telephone | 336-236-0165
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 11000
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License Number State | NC
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