Provider Demographics
NPI:1528673076
Name:RAMNANI, POOJA (DMD)
Entity type:Individual
Prefix:
First Name:POOJA
Middle Name:
Last Name:RAMNANI
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 1:9611 CUSTER RD APT 2035
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6523
Mailing Address - Country:US
Mailing Address - Phone:904-704-0123
Mailing Address - Fax:
Practice Address - Street 1:3610 W UNIVERSITY DR STE 400
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75071-2952
Practice Address - Country:US
Practice Address - Phone:904-704-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-11
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190328831223G0001X
TX392201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice