Provider Demographics
NPI:1275620973
Name:KHRAMOY, VLADIMIR (DDS)
Entity Type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:
Last Name:KHRAMOY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6363 YORK RD
Mailing Address - Street 2:SUIGE 203
Mailing Address - City:PARMA HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44130-3031
Mailing Address - Country:US
Mailing Address - Phone:440-885-5354
Mailing Address - Fax:440-888-5112
Practice Address - Street 1:6363 YORK RD
Practice Address - Street 2:SUITE 203
Practice Address - City:PARMA HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44130-3031
Practice Address - Country:US
Practice Address - Phone:440-885-5354
Practice Address - Fax:440-888-5112
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30021687122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2532085Medicaid