Provider Demographics
NPI:1811015530
Name:OCAMPO, RAMON REDUTA (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMON
Middle Name:REDUTA
Last Name:OCAMPO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:DR
Other - First Name:RAMON
Other - Middle Name:REDUTA
Other - Last Name:OCAMPO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2727 MCKEE RD
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95127-1827
Mailing Address - Country:US
Mailing Address - Phone:408-259-5545
Mailing Address - Fax:408-259-5565
Practice Address - Street 1:2727 MCKEE RD
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95127-1827
Practice Address - Country:US
Practice Address - Phone:408-259-5545
Practice Address - Fax:408-259-5565
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41500122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist