Individual provider Active NPI

Karen Y Jo, DDS

  • Periodontics
  • Silver Spring, MD
National Provider Identifier
1245729557
Registry record updated Feb 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
16867 Issued in MD
Practice address
10801 Lockwood Dr Ste 240
Silver Spring, MD 20901-1563
Phone
(301) 681-4812
NPI assigned
May 2, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 7, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Periodontics 1223P0300X 16867 MD Primary

Addresses

Primary practice location

10801 Lockwood Dr Ste 240
Silver Spring, MD 20901-1563

Mailing address

2115 Henson Norris St
Rockville, MD 20850-6578
Phone (240) 449-7419

Other practice location 1

101 Manning Dr
Chapel Hill, NC 27514-4220
Phone (984) 974-1485

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180806002097 NC Order and Referring Only - DentistPractitioner - Dentist 1850649914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16867MDMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Duane Bennett DDS MSD LLC Periodontics CurrentSince Feb 9, 2025 Accepting new patients
Craig M. Gayton DDS P.C. Periodontics PastSince Feb 9, 2025 Accepting new patients

Locations

10801 Lockwood Dr
Ste 240
Silver Spring, MD 20901
Phone (301) 681-4812

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738886400000",
    "number": "1245729557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2115 HENSON NORRIS ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208506578",
            "telephone_number": "240-449-7419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10801 LOCKWOOD DR STE 240",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209011563",
            "telephone_number": "301-681-4812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "101 Manning Dr",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275144220",
            "country_code": "US",
            "telephone_number": "984-974-1485",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JO",
        "first_name": "KAREN",
        "middle_name": "Y",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-02",
        "last_updated": "2025-02-07",
        "certification_date": "2025-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "MD",
            "license": "16867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Silver Spring, MD

Sources for this page

Verify at the official NPI Registry.