Healthcare Provider Details

I. General information

NPI: 1811306202
Provider Name (Legal Business Name): N. RAMZI PROFESSIONAL DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2014
Last Update Date: 08/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16406 WHITTIER BLVD
WHITTIER CA
90603-3043
US

IV. Provider business mailing address

16406 E WHITTIER BLVD
WHITTIER CA
90603
US

V. Phone/Fax

Practice location:
  • Phone: 562-694-0396
  • Fax: 562-902-1184
Mailing address:
  • Phone: 562-694-0396
  • Fax: 562-902-1184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number41670
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number49419
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number55220
License Number StateCA

VIII. Authorized Official

Name: NADER RAMZI
Title or Position: PRESIDENT
Credential: DDS
Phone: 562-694-0396