Provider Demographics
NPI:1790883098
Name:HENRY J. RAMIREZ, D.D.S., INC.
Entity Type:Organization
Organization Name:HENRY J. RAMIREZ, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-423-2447
Mailing Address - Street 1:1016 SOQUEL AVE
Mailing Address - Street 2:STE. A
Mailing Address - City:SANTA CRUZ
Mailing Address - State:CA
Mailing Address - Zip Code:95062-2104
Mailing Address - Country:US
Mailing Address - Phone:831-423-2447
Mailing Address - Fax:831-423-7925
Practice Address - Street 1:1016 SOQUEL AVE
Practice Address - Street 2:STE. A
Practice Address - City:SANTA CRUZ
Practice Address - State:CA
Practice Address - Zip Code:95062-2104
Practice Address - Country:US
Practice Address - Phone:831-423-2447
Practice Address - Fax:831-423-7925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA278231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA27823OtherDENTAL LICENSE