Provider Demographics
NPI:1780204388
Name:RAMIREZ, MARIBEL (RDH)
Entity Type:Individual
Prefix:
First Name:MARIBEL
Middle Name:
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:MARIBEL
Other - Middle Name:R
Other - Last Name:HERNANCEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:150 TEJAS PL
Mailing Address - Street 2:
Mailing Address - City:NIPOMO
Mailing Address - State:CA
Mailing Address - Zip Code:93444-9123
Mailing Address - Country:US
Mailing Address - Phone:805-931-2535
Mailing Address - Fax:
Practice Address - Street 1:2120 CIENAGA ST
Practice Address - Street 2:
Practice Address - City:OCEANO
Practice Address - State:CA
Practice Address - Zip Code:93445-9016
Practice Address - Country:US
Practice Address - Phone:805-994-2103
Practice Address - Fax:805-994-2195
Is Sole Proprietor?:No
Enumeration Date:2020-04-23
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist