Provider Demographics
NPI:1922708445
Name:RAGY STEFAN DDS INC
Entity Type:Organization
Organization Name:RAGY STEFAN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:
Authorized Official - Last Name:HERNANDEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-770-2251
Mailing Address - Street 1:5253 LAMPSON AVE
Mailing Address - Street 2:
Mailing Address - City:GARDEN GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:92845-1953
Mailing Address - Country:US
Mailing Address - Phone:949-293-8024
Mailing Address - Fax:
Practice Address - Street 1:5253 LAMPSON AVE
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92845-1953
Practice Address - Country:US
Practice Address - Phone:949-293-8024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-03
Last Update Date:2023-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty