=====================================================
General NPI Number Information
=====================================================
NPI Number | 1528589868
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | KAREN JANET SAAVEDRA-CHAVEZ DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2017
-----------------------------------------------------
Last Update Date | 09/26/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 124 VALLEY VISTA DR
-----------------------------------------------------
City | WOODSTOCK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22664-1608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-459-9333
-----------------------------------------------------
Fax | 540-459-1809
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 124 VALLEY VISTA DR
-----------------------------------------------------
City | WOODSTOCK
-----------------------------------------------------
State | VA
-----------------------------------------------------
Zip | 22664-1608
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 540-459-9333
-----------------------------------------------------
Fax | 540-459-1809
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 15026
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 0401418567
-----------------------------------------------------
License Number State | VA
-----------------------------------------------------