Provider Demographics
NPI:1518233550
Name:BOGDASAROVA, KARINA (DDS)
Entity Type:Individual
Prefix:DR
First Name:KARINA
Middle Name:
Last Name:BOGDASAROVA
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 1:2332 HARDESTY CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43204-2841
Mailing Address - Country:US
Mailing Address - Phone:720-891-6090
Mailing Address - Fax:
Practice Address - Street 1:2332 HARDESTY CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43204-2841
Practice Address - Country:US
Practice Address - Phone:720-891-6090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-23
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0238551223P0221X
GADN0147591223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry