MEDICARE: RAMIRO GANESH DDS, PC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376917534
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RAMIRO GANESH DDS, PC.

Provider Business Mailing Address
First Line	:	5405 S PLEASANT VALLEY RD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78744-3870
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5405 S PLEASANT VALLEY RD
Second Line	:	SUITE 100
City	:	AUSTIN
State	:	TX
Zip	:	78744-3870
Country	:	US
Telephone Number	:	310-745-6062
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. RAMIRO GANESH
Credential	:
Telephone Number	:	310-745-6062

Provider Enumeration Date	:	11/25/2015
Last Update Date	:	02/23/2016

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