Provider Demographics
NPI:1265650808
Name:SHEPPARD, KAREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 ALA MOANA BLVD APT 1409
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-1411
Mailing Address - Country:US
Mailing Address - Phone:425-293-2727
Mailing Address - Fax:
Practice Address - Street 1:500 ALA MOANA BLVD # 7-300
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-4920
Practice Address - Country:US
Practice Address - Phone:808-201-6092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2018-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI26591223G0001X
WADE78521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice