Provider Demographics
NPI:1225453152
Name:RAMOS ORTIZ, JAMES (DMD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:RAMOS ORTIZ
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CAPTAINS DR
Mailing Address - Street 2:
Mailing Address - City:WEST BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11704-8202
Mailing Address - Country:US
Mailing Address - Phone:631-365-0693
Mailing Address - Fax:
Practice Address - Street 1:38 CAPTAINS DR
Practice Address - Street 2:
Practice Address - City:WEST BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11704-8202
Practice Address - Country:US
Practice Address - Phone:631-365-0693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-01
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0581761223G0001X, 1223P0300X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program