Provider Demographics
NPI:1588686117
Name:KARAMYAN, KENNETH (DDS)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:KARAMYAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:KAREN
Other - Middle Name:
Other - Last Name:KARAMYAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2920 LYON ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94123-3226
Mailing Address - Country:US
Mailing Address - Phone:415-737-0430
Mailing Address - Fax:818-785-0491
Practice Address - Street 1:2920 LYON ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-3226
Practice Address - Country:US
Practice Address - Phone:415-737-0430
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA506181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA50618OtherLICENSE #
CA200569125OtherTAX ID