Provider Demographics
NPI:1538443163
Name:GANESH, RAMIRO (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMIRO
Middle Name:
Last Name:GANESH
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 DEL CURTO RD # 10
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-4822
Mailing Address - Country:US
Mailing Address - Phone:310-745-6062
Mailing Address - Fax:
Practice Address - Street 1:9021 GOODNIGHT RANCH BLVD UNIT 1320
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78747-1682
Practice Address - Country:US
Practice Address - Phone:512-580-3601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-30
Last Update Date:2024-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX284521223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice