Provider Demographics
NPI:1598316325
Name:RAMOS, ROXANNE IRIS NICOLAS (DMD)
Entity Type:Individual
Prefix:
First Name:ROXANNE IRIS
Middle Name:NICOLAS
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20645 E CLIMBER DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91789-3855
Mailing Address - Country:US
Mailing Address - Phone:909-967-4745
Mailing Address - Fax:
Practice Address - Street 1:20645 E CLIMBER DR
Practice Address - Street 2:
Practice Address - City:DIAMOND BAR
Practice Address - State:CA
Practice Address - Zip Code:91789-3855
Practice Address - Country:US
Practice Address - Phone:909-967-4745
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-23
Last Update Date:2019-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA104431122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist