Healthcare Provider Details

I. General information

NPI: 1437380177
Provider Name (Legal Business Name): KATIE A RAMAGE DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/29/2009
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4212 N 16TH ST
PHOENIX AZ
85016-5319
US

IV. Provider business mailing address

409 W MAIN ST
PAYSON AZ
85541-5487
US

V. Phone/Fax

Practice location:
  • Phone: 602-263-1592
  • Fax:
Mailing address:
  • Phone: 928-472-8400
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD07821
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberD07821
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: