Provider Demographics
NPI:1194720045
Name:RAMSEY, LADY-JEAN M (DMD)
Entity type:Individual
Prefix:DR
First Name:LADY-JEAN
Middle Name:M
Last Name:RAMSEY
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 1:9095 N HESS ST STE 201
Mailing Address - Street 2:
Mailing Address - City:HAYDEN
Mailing Address - State:ID
Mailing Address - Zip Code:83835-9827
Mailing Address - Country:US
Mailing Address - Phone:208-772-4500
Mailing Address - Fax:
Practice Address - Street 1:9095 N HESS ST STE 201
Practice Address - Street 2:
Practice Address - City:HAYDEN
Practice Address - State:ID
Practice Address - Zip Code:83835-9827
Practice Address - Country:US
Practice Address - Phone:208-772-4500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD53291223G0001X
ORD76081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice