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NPI Code Detail

MEDICARE: CRN DENTAL PLLC

MEDICARE: CRN DENTAL PLLC
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
1204E00000XOral & Maxillofacial Surgery (D.M.D.)

General Provider Information

NPI Number : 1518814292
Entity Type Code : Organization
Provider Name (Legal Business Name) : CRN DENTAL PLLC
Provider Business Mailing Address
First Line : 15510 LIVERNOIS AVE
Second Line :
City : DETROIT
State : MI
Zip : 48238-1343
Country : US
Telephone Number : 313-217-0014
Fax Number : 313-246-1886
Provider Business Practice Location Address
First Line : 15510 LIVERNOIS AVE
Second Line :
City : DETROIT
State : MI
Zip : 48238-1343
Country : US
Telephone Number : 313-217-0014
Fax Number : 313-246-1886
Authorized Official
Title or Position : OWNER
Name : DR. CARLOS A RAMIREZ-NEYRA
Credential : MD, DDS
Telephone Number : 248-890-9833
Provider Enumeration Date : 03/12/2026
Last Update Date : 03/12/2026

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