Provider Demographics
NPI:1073521001
Name:MCANDREW, KAREN SONNONE (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:SONNONE
Last Name:MCANDREW
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:MARIE
Other - Last Name:SONNONE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:10442 PATTERSON AVENUE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238
Mailing Address - Country:US
Mailing Address - Phone:804-741-8689
Mailing Address - Fax:804-741-8696
Practice Address - Street 1:10442 PATTERSON AVENUE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238
Practice Address - Country:US
Practice Address - Phone:804-741-8689
Practice Address - Fax:804-741-8696
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010087091223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA8400105Medicaid
U74256Medicare UPIN