Provider Demographics
NPI:1508134040
Name:KARNAVY, TANYA (DDS)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:KARNAVY
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 1:1818 MOUNTAIN VIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80501-3253
Mailing Address - Country:US
Mailing Address - Phone:303-651-3733
Mailing Address - Fax:303-485-5380
Practice Address - Street 1:1818 MOUNTAIN VIEW AVE
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80501-3253
Practice Address - Country:US
Practice Address - Phone:303-651-3733
Practice Address - Fax:303-485-5380
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2011-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI23551223P0221X
CA603881223P0221X
CO106111223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry