Provider Demographics
NPI:1437211455
Name:HOMANFAR, RAMIN (DDS)
Entity Type:Individual
Prefix:
First Name:RAMIN
Middle Name:
Last Name:HOMANFAR
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 1:5420 KIETZKE LN STE 201
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2062
Mailing Address - Country:US
Mailing Address - Phone:775-827-5511
Mailing Address - Fax:775-852-4154
Practice Address - Street 1:5420 KIETZKE LN STE 201
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2062
Practice Address - Country:US
Practice Address - Phone:775-827-5511
Practice Address - Fax:775-852-4154
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV29391223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0001XDental ProvidersDentistDental Public Health