Provider Demographics
NPI:1124411574
Name:RAMIN HATAMI DDS A PROFESSIONAL CORP
Entity Type:Organization
Organization Name:RAMIN HATAMI DDS A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RAMIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HATAMI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-888-8824
Mailing Address - Street 1:23727 ROSCOE BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91304-3041
Mailing Address - Country:US
Mailing Address - Phone:818-888-8824
Mailing Address - Fax:818-888-8247
Practice Address - Street 1:23727 ROSCOE BLVD
Practice Address - Street 2:
Practice Address - City:WEST HILLS
Practice Address - State:CA
Practice Address - Zip Code:91304-3041
Practice Address - Country:US
Practice Address - Phone:818-888-8824
Practice Address - Fax:818-888-8247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-10
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51182122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty