MEDICARE: JAIME A RAMISCAL DDS

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	122300000X	Dentist	41525	CA
2	1223G0001X	General Practice Dentistry	41525	CA

General Provider Information

NPI Number	:	1497974836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIME A RAMISCAL DDS

Provider Business Mailing Address
First Line	:	1444 N POINSETTIA PL
Second Line	:	102
City	:	LOS ANGELES
State	:	CA
Zip	:	90046-4364
Country	:	US
Telephone Number	:	323-876-5820
Fax Number	:

Provider Business Practice Location Address
First Line	:	8023 BEVERLY BLVD
Second Line	:	# 3
City	:	WEST HOLLYWOOD
State	:	CA
Zip	:	90048-4539
Country	:	US
Telephone Number	:	323-782-0098
Fax Number	:

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

Provider Enumeration Date	:	04/24/2007
Last Update Date	:	09/11/2025

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