Provider Demographics
NPI:1679631162
Name:ROBERT D. RAMIREZ DMD . APC
Entity type:Organization
Organization Name:ROBERT D. RAMIREZ DMD . APC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:D
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:916-774-9920
Mailing Address - Street 1:2436 PROFESSIONAL DR STE 200
Mailing Address - Street 2:
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7773
Mailing Address - Country:US
Mailing Address - Phone:916-774-9920
Mailing Address - Fax:916-774-1063
Practice Address - Street 1:2436 PROFESSIONAL DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7773
Practice Address - Country:US
Practice Address - Phone:916-774-9920
Practice Address - Fax:916-774-1063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADG 342001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty