Provider Demographics
NPI:1205920147
Name:EZAKI, RAMSEY ALAN (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMSEY
Middle Name:ALAN
Last Name:EZAKI
Suffix:
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 1:16336 WHITTIER BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90603-2900
Mailing Address - Country:US
Mailing Address - Phone:562-947-9958
Mailing Address - Fax:562-943-6751
Practice Address - Street 1:16336 WHITTIER BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90603-2900
Practice Address - Country:US
Practice Address - Phone:562-947-9958
Practice Address - Fax:562-943-6751
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2013-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA286821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice