Provider Demographics
NPI:1699182469
Name:BADHAN, RAMANDEEP (DDS)
Entity Type:Individual
Prefix:
First Name:RAMANDEEP
Middle Name:
Last Name:BADHAN
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 1:5751 W SANTA ANA AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-7516
Mailing Address - Country:US
Mailing Address - Phone:559-473-6281
Mailing Address - Fax:
Practice Address - Street 1:5751 W SANTA ANA AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-7516
Practice Address - Country:US
Practice Address - Phone:559-473-6281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA636111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice