Provider Demographics
NPI:1740311869
Name:RAMOS, RAYMOND DELA PENA (DMD)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:DELA PENA
Last Name:RAMOS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 BREEZEWALK DR
Mailing Address - Street 2:
Mailing Address - City:VALLEJO
Mailing Address - State:CA
Mailing Address - Zip Code:94591-7145
Mailing Address - Country:US
Mailing Address - Phone:707-315-8965
Mailing Address - Fax:
Practice Address - Street 1:2440 N TEXAS ST
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-1602
Practice Address - Country:US
Practice Address - Phone:707-422-4600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-08
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice