Provider Demographics
NPI:1265579379
Name:ZEREN, KARL JOSEPH (DDS)
Entity type:Individual
Prefix:DR
First Name:KARL
Middle Name:JOSEPH
Last Name:ZEREN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9515 DEERECO RD
Mailing Address - Street 2:SUITE 308
Mailing Address - City:TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-2116
Mailing Address - Country:US
Mailing Address - Phone:410-252-0871
Mailing Address - Fax:410-252-0431
Practice Address - Street 1:9515 DEERECO RD
Practice Address - Street 2:SUITE 308
Practice Address - City:TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-2116
Practice Address - Country:US
Practice Address - Phone:410-252-0871
Practice Address - Fax:410-252-0431
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD59371223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD11698101Medicare UPIN
MDR974Medicare ID - Type Unspecified