Provider Demographics
NPI:1699386698
Name:MURAYAMA, RONALD K (DDS)
Entity type:Individual
Prefix:DR
First Name:RONALD
Middle Name:K
Last Name:MURAYAMA
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 1:32 REGATO
Mailing Address - Street 2:
Mailing Address - City:RANCHO SANTA MARGARITA
Mailing Address - State:CA
Mailing Address - Zip Code:92688-3004
Mailing Address - Country:US
Mailing Address - Phone:949-923-0486
Mailing Address - Fax:
Practice Address - Street 1:122 AGATE AVE STE A
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92662-1071
Practice Address - Country:US
Practice Address - Phone:949-675-3636
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-12
Last Update Date:2020-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA313381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice