Provider Demographics
NPI:1316211808
Name:CORINA RAMIREZ, DDS, INC
Entity Type:Organization
Organization Name:CORINA RAMIREZ, DDS, INC
Other - Org Name:CHILDRENS DENTAL GROUP-EAGLE ROCK
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CORINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-987-2175
Mailing Address - Street 1:4444 TWEEDY BLVD
Mailing Address - Street 2:
Mailing Address - City:SOUTH GATE
Mailing Address - State:CA
Mailing Address - Zip Code:90280-6304
Mailing Address - Country:US
Mailing Address - Phone:323-564-2444
Mailing Address - Fax:323-923-1088
Practice Address - Street 1:2700 COLORADO BLVD
Practice Address - Street 2:SUITE 263
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90041-1081
Practice Address - Country:US
Practice Address - Phone:323-987-2175
Practice Address - Fax:323-543-4247
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-29
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA526761223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty