Provider Demographics
NPI:1083872980
Name:RAMISETTY, CHETANA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHETANA
Middle Name:L
Last Name:RAMISETTY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44208 NAVAJO DR
Mailing Address - Street 2:
Mailing Address - City:ASHBURN
Mailing Address - State:VA
Mailing Address - Zip Code:20147
Mailing Address - Country:US
Mailing Address - Phone:703-956-0981
Mailing Address - Fax:
Practice Address - Street 1:1 WYOMING STREET
Practice Address - Street 2:MVH - DEPARTMENT OF MEDICAL/DENTAL EDUCATION
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409
Practice Address - Country:US
Practice Address - Phone:703-956-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-28
Last Update Date:2008-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH27091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice