Provider Demographics
NPI:1497474399
Name:RAMOS, CLESTHER (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLESTHER
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 N REESE PL
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91506-1119
Mailing Address - Country:US
Mailing Address - Phone:818-468-6918
Mailing Address - Fax:
Practice Address - Street 1:400 W ELMWOOD AVE
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91506-3304
Practice Address - Country:US
Practice Address - Phone:818-841-8010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2022-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA107777122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist