Provider Demographics
NPI:1619967338
Name:KAZEMI, RAMIN H
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:H
Last Name:KAZEMI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7230 PEPPERMILL LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40228-1660
Mailing Address - Country:US
Mailing Address - Phone:502-239-1345
Mailing Address - Fax:502-231-5982
Practice Address - Street 1:7230 PEPPERMILL LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40228-1660
Practice Address - Country:US
Practice Address - Phone:502-239-1345
Practice Address - Fax:502-231-5982
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY73461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY4765OtherDORAL DENTAL SERVICES