Provider Demographics
NPI:1902383961
Name:RAMCHARAN, CASSANDRA JEAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASSANDRA
Middle Name:JEAN
Last Name:RAMCHARAN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:CASSANDRA
Other - Middle Name:JEAN
Other - Last Name:HANKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1050 W ELM AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:HERMISTON
Mailing Address - State:OR
Mailing Address - Zip Code:97838-2714
Mailing Address - Country:US
Mailing Address - Phone:503-410-8213
Mailing Address - Fax:
Practice Address - Street 1:1050 W ELM AVE STE 230
Practice Address - Street 2:
Practice Address - City:HERMISTON
Practice Address - State:OR
Practice Address - Zip Code:97838
Practice Address - Country:US
Practice Address - Phone:541-303-7084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-23
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD10864122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist