Healthcare Provider Details

I. General information

NPI: 1760303010
Provider Name (Legal Business Name): DINA RUTH RAMIREZ DE SANDOVAL DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 E GAGE AVE
LOS ANGELES CA
90001-1771
US

IV. Provider business mailing address

6710 HAYVENHURST AVE APT 74
VAN NUYS CA
91406-5737
US

V. Phone/Fax

Practice location:
  • Phone: 323-983-4000
  • Fax:
Mailing address:
  • Phone: 818-255-2244
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number113596
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: