Provider Demographics
NPI:1629293774
Name:MACASAET, RAMIL ALMENDRALA (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMIL
Middle Name:ALMENDRALA
Last Name:MACASAET
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 1:19045 GAULT ST
Mailing Address - Street 2:UNIT #11
Mailing Address - City:RESEDA
Mailing Address - State:CA
Mailing Address - Zip Code:91335-3953
Mailing Address - Country:US
Mailing Address - Phone:818-268-1590
Mailing Address - Fax:818-996-6569
Practice Address - Street 1:19100 VENTURA BLVD
Practice Address - Street 2:SUITE #1
Practice Address - City:TARZANA
Practice Address - State:CA
Practice Address - Zip Code:91356-3239
Practice Address - Country:US
Practice Address - Phone:818-268-1634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-16
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA55289122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist