Healthcare Provider Details

I. General information

NPI: 1558596395
Provider Name (Legal Business Name): RAMTIN KHAEF DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/22/2009
Last Update Date: 06/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9907 WALKER ST
CYPRESS CA
90630
US

IV. Provider business mailing address

27758 SANTA MARGARITA PKWY # 382
MISSION VIEJO CA
92691-6709
US

V. Phone/Fax

Practice location:
  • Phone: 714-581-8585
  • Fax:
Mailing address:
  • Phone: 949-510-0225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number53809
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number53809
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: