Provider Demographics
NPI:1689781833
Name:VINJAMURI, RAMESH K (DDS)
Entity Type:Individual
Prefix:DR
First Name:RAMESH
Middle Name:K
Last Name:VINJAMURI
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 1:823 WESTCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455
Mailing Address - Country:US
Mailing Address - Phone:718-893-0080
Mailing Address - Fax:
Practice Address - Street 1:823 WESTCHESTER AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455
Practice Address - Country:US
Practice Address - Phone:718-893-0080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049393122300000X
NJ22DI02143100122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02169253Medicaid