Provider Demographics
NPI:1699962670
Name:RAMA OSKOUIAN, DMD, PLLC
Entity type:Organization
Organization Name:RAMA OSKOUIAN, DMD, PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:
Authorized Official - Last Name:EMENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-402-8393
Mailing Address - Street 1:17000 140TH AVE NE
Mailing Address - Street 2:SUITE 302
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6928
Mailing Address - Country:US
Mailing Address - Phone:425-402-8393
Mailing Address - Fax:425-402-8394
Practice Address - Street 1:17000 140TH AVE NE
Practice Address - Street 2:SUITE 302
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6928
Practice Address - Country:US
Practice Address - Phone:425-402-8393
Practice Address - Fax:425-402-8394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-03
Last Update Date:2007-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000103381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5053665Medicaid