Provider Demographics
NPI:1033742002
Name:SARMICANIC DENTAL CORP
Entity Type:Organization
Organization Name:SARMICANIC DENTAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMINA
Authorized Official - Middle Name:
Authorized Official - Last Name:SARMICANIC
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-525-5178
Mailing Address - Street 1:6167 BRISTOL PKWY STE 215
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6610
Mailing Address - Country:US
Mailing Address - Phone:310-525-5178
Mailing Address - Fax:310-933-4796
Practice Address - Street 1:6167 BRISTOL PKWY STE 215
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-6610
Practice Address - Country:US
Practice Address - Phone:310-525-5178
Practice Address - Fax:310-933-4796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA64399OtherDENTIST