Provider Demographics
NPI:1588047906
Name:HARNICK, KARI SUZANNE (DDS, MS)
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:SUZANNE
Last Name:HARNICK
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10425 MONTGOMERY PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111
Mailing Address - Country:US
Mailing Address - Phone:505-323-0500
Mailing Address - Fax:505-323-0600
Practice Address - Street 1:10425 MONTGOMERY PKWY NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111
Practice Address - Country:US
Practice Address - Phone:505-323-0500
Practice Address - Fax:505-323-0600
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2019-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NMDD48021223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program