MEDICARE: DR. ALYSSA NICOLE RAMIREZ DDS

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	DD5644	NM

General Provider Information

NPI Number	:	1497480651
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALYSSA NICOLE RAMIREZ DDS

Provider Business Mailing Address
First Line	:	9 INDIAN LN
Second Line	:
City	:	MESILLA PARK
State	:	NM
Zip	:	88047-9671
Country	:	US
Telephone Number	:	575-494-6356
Fax Number	:

Provider Business Practice Location Address
First Line	:	2205 S SOLANO DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88001-5503
Country	:	US
Telephone Number	:	575-522-7320
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2022
Last Update Date	:	07/25/2022

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