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General NPI Number Information
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NPI Number | 1326576745
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Entity Type | Individual
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Provider Name | KAREN JUANA KING D.D.S
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Gender | Female
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Dates
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Enumeration Date | 05/30/2017
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 1523 W MAIN ST STE 108
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City | EL CENTRO
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State | CA
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Zip | 92243-2282
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Country | US
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Telephone | 760-615-0823
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Fax |
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Provider Business Mailing Address
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Address Line | 6244 JAPATUL HIGHLANDS RD
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City | ALPINE
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State | CA
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Zip | 91901-3318
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Country | US
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Telephone | 619-822-4359
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 35013
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License Number State | TX
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Taxonomy #2
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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 #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 35013
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License Number State | TX
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