Provider Demographics
NPI:1699156547
Name:SARAVANAN RAM DDS INC.
Entity type:Organization
Organization Name:SARAVANAN RAM DDS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAVANAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-268-7478
Mailing Address - Street 1:16311 VENTURA BLVD
Mailing Address - Street 2:STE 1250
Mailing Address - City:ENCINO
Mailing Address - State:CA
Mailing Address - Zip Code:91436-2124
Mailing Address - Country:US
Mailing Address - Phone:818-789-0555
Mailing Address - Fax:818-789-5011
Practice Address - Street 1:16311 VENTURA BLVD
Practice Address - Street 2:STE 1250
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2124
Practice Address - Country:US
Practice Address - Phone:818-789-0555
Practice Address - Fax:818-789-5011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-17
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59462122300000X, 261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB204235Medicare UPIN