Provider Demographics
NPI:1376967869
Name:KIMZEY, KAREN (DDS)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:KIMZEY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:DOAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9309 OFFICE PARK CIR STE 100
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-8072
Mailing Address - Country:US
Mailing Address - Phone:916-423-3636
Mailing Address - Fax:
Practice Address - Street 1:9309 OFFICE PARK CIR STE 100
Practice Address - Street 2:
Practice Address - City:ELK GROVE
Practice Address - State:CA
Practice Address - Zip Code:95758-8072
Practice Address - Country:US
Practice Address - Phone:916-423-3616
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-05
Last Update Date:2025-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA635121223E0200X, 1223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program