Provider Demographics
NPI:1407877087
Name:SUMABAT, RAMON (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:
Last Name:SUMABAT
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 1:285 S PALM CANYON DR STE D7
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-6360
Mailing Address - Country:US
Mailing Address - Phone:760-320-2780
Mailing Address - Fax:760-320-5790
Practice Address - Street 1:285 S PALM CANYON DR STE D7
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-6360
Practice Address - Country:US
Practice Address - Phone:760-320-2780
Practice Address - Fax:760-320-5790
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA976869OtherUNITED CONCORDIA
CAB42426-01OtherDENTI-CAL