Provider Demographics
NPI:1134242498
Name:YOO, KAREN MIHO (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:MIHO
Last Name:YOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:MIHO
Other - Last Name:OGA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:20461 TULSA ST
Mailing Address - Street 2:
Mailing Address - City:CHATSWORTH
Mailing Address - State:CA
Mailing Address - Zip Code:91311-1724
Mailing Address - Country:US
Mailing Address - Phone:415-595-9055
Mailing Address - Fax:
Practice Address - Street 1:1960 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:CA
Practice Address - Zip Code:91340-1671
Practice Address - Country:US
Practice Address - Phone:818-361-1717
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-09
Last Update Date:2022-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA516311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice