Provider Demographics
NPI:1538230081
Name:KOOKEN, KAREN BRAUN (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:BRAUN
Last Name:KOOKEN
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 1:32156 CASTLE CT STE 108
Mailing Address - Street 2:
Mailing Address - City:EVERGREEN
Mailing Address - State:CO
Mailing Address - Zip Code:80439-9500
Mailing Address - Country:US
Mailing Address - Phone:303-567-2597
Mailing Address - Fax:303-679-3037
Practice Address - Street 1:32156 CASTLE CT STE 108
Practice Address - Street 2:
Practice Address - City:EVERGREEN
Practice Address - State:CO
Practice Address - Zip Code:80439-9500
Practice Address - Country:US
Practice Address - Phone:303-567-2597
Practice Address - Fax:303-679-3037
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO69021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO6902OtherDENTAL LICENSE NUMBER