Provider Demographics
NPI:1083755029
Name:RAMCHARAN, VYASA (DMD)
Entity Type:Individual
Prefix:DR
First Name:VYASA
Middle Name:
Last Name:RAMCHARAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:V.
Other - Middle Name:
Other - Last Name:RAMCHARAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PROFESSI ASSOCIATION
Mailing Address - Street 1:2081 DUNDEE DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-4104
Mailing Address - Country:US
Mailing Address - Phone:407-599-1221
Mailing Address - Fax:407-599-1220
Practice Address - Street 1:2081 DUNDEE DR
Practice Address - Street 2:
Practice Address - City:WINTER PARK
Practice Address - State:FL
Practice Address - Zip Code:32792-4104
Practice Address - Country:US
Practice Address - Phone:407-599-1221
Practice Address - Fax:407-599-1220
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN118691223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery