Provider Demographics
NPI:1073111647
Name:RAMANDI, MELISSA YOUSEFI (DMD)
Entity Type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:YOUSEFI
Last Name:RAMANDI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E 14TH ST APT 1608
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60605-3672
Mailing Address - Country:US
Mailing Address - Phone:310-709-4764
Mailing Address - Fax:
Practice Address - Street 1:6 W LINCOLN HWY
Practice Address - Street 2:
Practice Address - City:MERRILLVILLE
Practice Address - State:IN
Practice Address - Zip Code:46410-5446
Practice Address - Country:US
Practice Address - Phone:219-472-2275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-15
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12013503A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist