Provider Demographics
NPI:1811427883
Name:KAREM, GRACE E (DMD)
Entity type:Individual
Prefix:DR
First Name:GRACE
Middle Name:E
Last Name:KAREM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 CHAMPIONS WAY
Mailing Address - Street 2:
Mailing Address - City:SIMPSONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40067-6554
Mailing Address - Country:US
Mailing Address - Phone:502-257-2274
Mailing Address - Fax:
Practice Address - Street 1:627 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:SHELBYVILLE
Practice Address - State:KY
Practice Address - Zip Code:40065-1131
Practice Address - Country:US
Practice Address - Phone:502-633-3735
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-13
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN104781223G0001X
KY104811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice