Provider Demographics
NPI:1669610440
Name:RICHARDS, KAREN B (DMD - PERIODONTIST)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:B
Last Name:RICHARDS
Suffix:
Gender:F
Credentials:DMD - PERIODONTIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1061
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARA
Mailing Address - State:UT
Mailing Address - Zip Code:84765-1061
Mailing Address - Country:US
Mailing Address - Phone:541-772-0109
Mailing Address - Fax:
Practice Address - Street 1:1601 E MCANDREWS RD
Practice Address - Street 2:SUITE B
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-5300
Practice Address - Country:US
Practice Address - Phone:541-772-0109
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-01
Last Update Date:2023-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD90111223P0300X
UT3194089920124Q00000X
UT319408-99241223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No124Q00000XDental ProvidersDental Hygienist