Provider Demographics
NPI:1154420677
Name:THOMPSON, KARLA GUINN (DDS)
Entity type:Individual
Prefix:DR
First Name:KARLA
Middle Name:GUINN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:KARLA
Other - Middle Name:LAWRENCE
Other - Last Name:GUINN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1414 FAIR OAKS AVE STE 7
Mailing Address - Street 2:
Mailing Address - City:SOUTH PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91030-6217
Mailing Address - Country:US
Mailing Address - Phone:626-200-9934
Mailing Address - Fax:626-788-5911
Practice Address - Street 1:1414 FAIR OAKS AVE STE 7
Practice Address - Street 2:
Practice Address - City:SOUTH PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91030-6217
Practice Address - Country:US
Practice Address - Phone:626-788-5911
Practice Address - Fax:626-399-0694
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA495381223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics