Provider Demographics
NPI:1093848673
Name:RAMESH MULCHANDANI DDS
Entity Type:Organization
Organization Name:RAMESH MULCHANDANI DDS
Other - Org Name:R M MULCHANDANI DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:D.D.S
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:MULCHANDANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-564-4417
Mailing Address - Street 1:12060 S CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90059-2839
Mailing Address - Country:US
Mailing Address - Phone:323-564-4417
Mailing Address - Fax:
Practice Address - Street 1:12060 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90059-2839
Practice Address - Country:US
Practice Address - Phone:323-564-4417
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RAMESH MULCHANDANI DDS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-03-13
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB 29388-01OtherMEDI-CAL PROVIDER NUMBER
CACGP168516OtherCCS
CA29388OtherDELTADENTAL