Provider Demographics
NPI:1861465726
Name:RAMIREZ, WASCAR ALEXI SR (DDS)
Entity Type:Individual
Prefix:MR
First Name:WASCAR
Middle Name:ALEXI
Last Name:RAMIREZ
Suffix:SR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10807 CORONA AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CORONA
Mailing Address - State:NY
Mailing Address - Zip Code:11368-3941
Mailing Address - Country:US
Mailing Address - Phone:719-760-3417
Mailing Address - Fax:718-760-3417
Practice Address - Street 1:10807 CORONA AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CORONA
Practice Address - State:NY
Practice Address - Zip Code:11368
Practice Address - Country:US
Practice Address - Phone:719-760-3417
Practice Address - Fax:718-760-3417
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0484861122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY443475OtherAETNA DMD
NY9176820OtherDORAL DENTAL IPA OF NY
NY02010199Medicaid