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General NPI Number Information
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NPI Number | 1699156547
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Entity Type | Organization
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Legal Business Name | SARAVANAN RAM DDS INC.
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 16311 VENTURA BLVD STE 1250
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-789-0555
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Fax | 818-789-5011
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BLVD STE 1250
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City | ENCINO
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State | CA
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Zip | 91436-2124
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Country | US
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Telephone | 818-789-0555
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Fax | 818-789-5011
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SARAVANAN RAM
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Credential | D.D.S.
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Telephone | 213-268-7478
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 59462
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 59462
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License Number State | CA
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