Provider Demographics
NPI:1861689408
Name:MAHER, RAMIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAMIN
Middle Name:
Last Name:MAHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3219 MCHENRY AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MODESTO
Mailing Address - State:CA
Mailing Address - Zip Code:95350-1457
Mailing Address - Country:US
Mailing Address - Phone:209-549-2400
Mailing Address - Fax:
Practice Address - Street 1:3219 MCHENRY AVE STE C
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95350-1457
Practice Address - Country:US
Practice Address - Phone:209-549-2400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA447361223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry