Individual provider Active NPI

Karen Konomi Wolf, DMD

  • Pediatric Dentistry
  • Beaufort, SC
National Provider Identifier
1952783094
Registry record updated Jan 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
8550 Issued in SC
Practice address
37 Sams Point Rd Ste B
Beaufort, SC 29907-2008
Phone
(865) 773-8687
NPI assigned
Jun 25, 2015
Last updated
Jan 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 8550 SC Primary

Addresses

Primary practice location

37 Sams Point Rd Ste B
Beaufort, SC 29907-2008

Mailing address

37 Sams Point Rd Ste B
Beaufort, SC 29907-2008
Phone (875) 773-8687

Other practice location 1

808 Wappoo Rd
Charleston, SC 29407-5865
Phone (843) 818-5437

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8550SCMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Zest Pediatric Dentistry Pediatric Dentistry CurrentSince Mar 6, 2022 Accepting new patients
Dentistry for Children of South Carolina PC Past Accepting new patients

Locations

37 Sams Point Rd
#B
Beaufort, SC 29907
Phone (843) 321-9944

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1435190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674777600000",
    "number": "1952783094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37 SAMS POINT RD STE B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072008",
            "telephone_number": "875-773-8687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 SAMS POINT RD STE B",
            "city": "BEAUFORT",
            "state": "SC",
            "postal_code": "299072008",
            "telephone_number": "865-773-8687"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "808 Wappoo Rd",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "SC",
            "postal_code": "294075865",
            "country_code": "US",
            "telephone_number": "843-818-5437",
            "fax_number": "843-725-1594",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WOLF",
        "first_name": "KAREN",
        "middle_name": "KONOMI",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-25",
        "last_updated": "2023-01-27",
        "certification_date": "2023-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "SC",
            "license": "8550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beaufort, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.