Provider Demographics
NPI:1891862157
Name:IVERS, KAREN J (DDS LLC)
Entity Type:Individual
Prefix:DR
First Name:KAREN
Middle Name:J
Last Name:IVERS
Suffix:
Gender:F
Credentials:DDS LLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5454 WISCONSIN AVE
Mailing Address - Street 2:STE 835
Mailing Address - City:CHEVY CHASE
Mailing Address - State:MD
Mailing Address - Zip Code:20815
Mailing Address - Country:US
Mailing Address - Phone:301-652-0656
Mailing Address - Fax:301-652-0752
Practice Address - Street 1:5454 WISCONSIN AVE
Practice Address - Street 2:STE 835
Practice Address - City:CHEVY CHASE
Practice Address - State:MD
Practice Address - Zip Code:20815-6941
Practice Address - Country:US
Practice Address - Phone:301-652-0656
Practice Address - Fax:301-652-0752
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD10952122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist