Healthcare Provider Details

I. General information

NPI: 1275033854
Provider Name (Legal Business Name): ENRIQUE RAMIREZ DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 03/20/2023
Certification Date: 03/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 CHILDRENS DR
COLUMBUS OH
43205
US

IV. Provider business mailing address

700 CHILDRENS DR
COLUMBUS OH
43205-2664
US

V. Phone/Fax

Practice location:
  • Phone: 614-722-5651
  • Fax: 614-722-5671
Mailing address:
  • Phone: 614-722-5651
  • Fax: 614-722-5671

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number36099
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number30.025807
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number30.025807
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: