MEDICARE: CRYSTAL CHARMAINE RAMDEO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN26651	FL
2	390200000X	Student in an Organized Health Care Education/Training Program
3	122300000X	Dentist	DT2908	HI
4	122300000X	Dentist	DN26551	FL

General Provider Information

NPI Number	:	1225611924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL CHARMAINE RAMDEO DMD

Provider Business Mailing Address
First Line	:	8918 LANTANA RD STE B
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6136
Country	:	US
Telephone Number	:	561-603-2504
Fax Number	:

Provider Business Practice Location Address
First Line	:	8918 LANTANA RD STE B
Second Line	:
City	:	LAKE WORTH
State	:	FL
Zip	:	33467-6136
Country	:	US
Telephone Number	:	561-801-1044
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/30/2021
Last Update Date	:	02/03/2025

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