MEDICARE: KAREN GUINN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	305R00000X	Preferred Provider Organization	31275	CA
2	122300000X	Dentist
3	1223S0112X	Oral and Maxillofacial Surgery (Dentist)
4	1223E0200X	Endodontics
5	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry

General Provider Information

NPI Number	:	1669693057
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAREN GUINN DDS

Provider Business Mailing Address
First Line	:	1175 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2505
Country	:	US
Telephone Number	:	626-578-1687
Fax Number	:	626-578-1594

Provider Business Practice Location Address
First Line	:	1175 E GREEN ST
Second Line	:
City	:	PASADENA
State	:	CA
Zip	:	91106-2505
Country	:	US
Telephone Number	:	626-578-1687
Fax Number	:	626-578-1594

Authorized Official
Title or Position	:	ORTHODONTIST
Name	:	DR. KAREN E GUINN
Credential	:	DDS
Telephone Number	:	626-578-1687

Provider Enumeration Date	:	05/01/2007
Last Update Date	:	08/22/2016

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