Provider Demographics
NPI:1225611924
Name:RAMDEO, CRYSTAL CHARMAINE (DMD)
Entity Type:Individual
Prefix:
First Name:CRYSTAL
Middle Name:CHARMAINE
Last Name:RAMDEO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6990 N CALUMET CIR
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-7006
Mailing Address - Country:US
Mailing Address - Phone:561-603-2504
Mailing Address - Fax:
Practice Address - Street 1:2623 S SEACREST BLVD STE 112
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7531
Practice Address - Country:US
Practice Address - Phone:561-806-6835
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-30
Last Update Date:2023-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT2908122300000X
390200000X
FLDN26551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Multi-Specialty