=====================================================
General NPI Number Information
=====================================================
NPI Number | 1285430272
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SERRANO RAMOS DENTAL CORPORATION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/20/2025
-----------------------------------------------------
Last Update Date | 02/22/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 33378 ALVARADO NILES RD
-----------------------------------------------------
City | UNION CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94587-3199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 510-487-3912
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 33378 ALVARADO NILES RD
-----------------------------------------------------
City | UNION CITY
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 94587-3199
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 408-806-4018
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DR. KRISTINE RAMOS
-----------------------------------------------------
Credential | DMD
-----------------------------------------------------
Telephone | 408-806-4018
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------