Provider Demographics
NPI:1972792612
Name:RAMOS DENTAL PC
Entity type:Organization
Organization Name:RAMOS DENTAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NESTOR
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:718-502-9974
Mailing Address - Street 1:3553 82ND ST
Mailing Address - Street 2:SUITE 1E
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-5162
Mailing Address - Country:US
Mailing Address - Phone:718-426-4176
Mailing Address - Fax:718-426-2392
Practice Address - Street 1:3553 82ND ST
Practice Address - Street 2:SUITE 1E
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-5162
Practice Address - Country:US
Practice Address - Phone:718-426-4176
Practice Address - Fax:718-426-2392
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-18
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02872099Medicaid