Provider Demographics
NPI:1144553900
Name:DEPAOLI, KAREN M (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:M
Last Name:DEPAOLI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 N HARBOR BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FULLERTON
Mailing Address - State:CA
Mailing Address - Zip Code:92835-4124
Mailing Address - Country:US
Mailing Address - Phone:714-441-2372
Mailing Address - Fax:714-441-2117
Practice Address - Street 1:1321 N HARBOR BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:FULLERTON
Practice Address - State:CA
Practice Address - Zip Code:92835-4124
Practice Address - Country:US
Practice Address - Phone:714-441-2372
Practice Address - Fax:714-441-2117
Is Sole Proprietor?:No
Enumeration Date:2009-09-11
Last Update Date:2014-04-16
Deactivation Date:2010-10-04
Deactivation Code:
Reactivation Date:2014-04-16
Provider Licenses
StateLicense IDTaxonomies
CA409281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice