Provider Demographics
NPI:1538359070
Name:HARRY KARNA D.D.S., A PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:HARRY KARNA D.D.S., A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:ARJUN
Authorized Official - Last Name:KARNA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-485-2800
Mailing Address - Street 1:12264 PERRIS BLVD
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92557-7418
Mailing Address - Country:US
Mailing Address - Phone:951-485-2800
Mailing Address - Fax:951-485-2802
Practice Address - Street 1:12264 PERRIS BLVD
Practice Address - Street 2:
Practice Address - City:MORENO VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92557
Practice Address - Country:US
Practice Address - Phone:951-485-2800
Practice Address - Fax:951-428-2800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-31
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA399711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA39971Medicaid
778550OtherUNITED CONCORDIA