Provider Demographics
NPI:1710245725
Name:KAREN PARVIN DMD PC
Entity Type:Organization
Organization Name:KAREN PARVIN DMD PC
Other - Org Name:COASTAL SMILE DESIGN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:PARVIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:757-233-9885
Mailing Address - Street 1:1464 MOUNT PLEASANT RD
Mailing Address - Street 2:SUITE 26
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23322-4043
Mailing Address - Country:US
Mailing Address - Phone:757-233-9885
Mailing Address - Fax:757-233-0182
Practice Address - Street 1:1464 MOUNT PLEASANT RD
Practice Address - Street 2:SUITE 26
Practice Address - City:CHESAPEAKE
Practice Address - State:VA
Practice Address - Zip Code:23322-4043
Practice Address - Country:US
Practice Address - Phone:757-233-9885
Practice Address - Fax:757-233-0182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-26
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401411126122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty