Healthcare Provider Details

I. General information

NPI: 1487894499
Provider Name (Legal Business Name): RAMYA RAMAMURTHY DDS,MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/03/2009
Last Update Date: 08/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 N CAPITOL AVE STE A1
SAN JOSE CA
95133-1902
US

IV. Provider business mailing address

750 N CAPITOL AVE SUITE A-1
SAN JOSE CA
95133-1913
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-2090
  • Fax: 408-259-2027
Mailing address:
  • Phone: 415-336-3569
  • Fax: 408-259-2027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number58070
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: