Provider Demographics
NPI:1992948459
Name:JACOBS, KAREN ELLEN (DDS)
Entity type:Individual
Prefix:DR
First Name:KAREN
Middle Name:ELLEN
Last Name:JACOBS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 HAMBLETON CT
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21208-3333
Mailing Address - Country:US
Mailing Address - Phone:410-653-9991
Mailing Address - Fax:
Practice Address - Street 1:3001 SOLLERS POINT RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21222-5340
Practice Address - Country:US
Practice Address - Phone:410-284-1414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD7845122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist