Provider Demographics
NPI:1821869710
Name:RAMASWAMY, HEERA
Entity Type:Individual
Prefix:
First Name:HEERA
Middle Name:
Last Name:RAMASWAMY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 WOODCLIFF BLVD
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4225
Mailing Address - Country:US
Mailing Address - Phone:732-858-4257
Mailing Address - Fax:
Practice Address - Street 1:2429 FREDERICK AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21223-2856
Practice Address - Country:US
Practice Address - Phone:443-836-4740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-10
Last Update Date:2024-02-20
Deactivation Date:2024-02-07
Deactivation Code:
Reactivation Date:2024-02-13
Provider Licenses
StateLicense IDTaxonomies
MD178821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice