Provider Demographics
NPI:1982762431
Name:SHAY, KAREN ENGELS (DMD)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ENGELS
Last Name:SHAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 EAST MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351
Mailing Address - Country:US
Mailing Address - Phone:606-784-4762
Mailing Address - Fax:606-784-4762
Practice Address - Street 1:165 EAST MAIN ST
Practice Address - Street 2:
Practice Address - City:MOREHEAD
Practice Address - State:KY
Practice Address - Zip Code:40351
Practice Address - Country:US
Practice Address - Phone:606-784-4762
Practice Address - Fax:606-784-4762
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5764122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY60057643Medicaid