Provider Demographics
NPI:1689851578
Name:KAMRAN RUINTAN DMD
Entity Type:Organization
Organization Name:KAMRAN RUINTAN DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KAMRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:RUINTAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:602-996-0166
Mailing Address - Street 1:10211 N 32ND ST
Mailing Address - Street 2:SUITE C-1
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3828
Mailing Address - Country:US
Mailing Address - Phone:602-996-0166
Mailing Address - Fax:602-996-1156
Practice Address - Street 1:10211 N 32ND ST
Practice Address - Street 2:SUITE C-1
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3828
Practice Address - Country:US
Practice Address - Phone:602-996-0166
Practice Address - Fax:602-996-1156
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-23
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ43101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty