Provider Demographics
NPI:1124689765
Name:OZA, KARAN HEMANG (DMD)
Entity type:Individual
Prefix:DR
First Name:KARAN
Middle Name:HEMANG
Last Name:OZA
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3216 PINERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:CHESAPEAKE
Mailing Address - State:VA
Mailing Address - Zip Code:23321-5404
Mailing Address - Country:US
Mailing Address - Phone:757-362-4803
Mailing Address - Fax:
Practice Address - Street 1:1301 BRIDGEPORT WAY STE 109
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23435-1960
Practice Address - Country:US
Practice Address - Phone:757-484-1444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-25
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.0321931223G0001X
VA04014166741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty