Provider Demographics
NPI:1245809078
Name:RAMA, DILLON NARESH (DMD)
Entity type:Individual
Prefix:DR
First Name:DILLON
Middle Name:NARESH
Last Name:RAMA
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 1:15301 CRYSTAL SPRINGS WAY
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40245-5295
Mailing Address - Country:US
Mailing Address - Phone:502-794-5690
Mailing Address - Fax:
Practice Address - Street 1:5200 N ARMENIA AVE
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33603-1408
Practice Address - Country:US
Practice Address - Phone:813-876-6930
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-24
Last Update Date:2021-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN25975122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist