Provider Demographics
NPI:1699850164
Name:BELTRAN, LOURDES RAMIREZ (DMD)
Entity Type:Individual
Prefix:DR
First Name:LOURDES
Middle Name:RAMIREZ
Last Name:BELTRAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6094 MOWRY AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:CA
Mailing Address - Zip Code:94560-4900
Mailing Address - Country:US
Mailing Address - Phone:510-791-6133
Mailing Address - Fax:510-793-4280
Practice Address - Street 1:6094 MOWRY AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:CA
Practice Address - Zip Code:94560-4900
Practice Address - Country:US
Practice Address - Phone:510-791-6133
Practice Address - Fax:510-793-4280
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist