Provider Demographics
NPI:1295740801
Name:RAMGOPAL, LAKSHMI (DMD)
Entity type:Individual
Prefix:DR
First Name:LAKSHMI
Middle Name:
Last Name:RAMGOPAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20445 PROSPECT RD
Mailing Address - Street 2:STE 8
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95129-4662
Mailing Address - Country:US
Mailing Address - Phone:408-253-8150
Mailing Address - Fax:408-366-1326
Practice Address - Street 1:20445 PROSPECT RD
Practice Address - Street 2:STE 8
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95129-4662
Practice Address - Country:US
Practice Address - Phone:408-253-8150
Practice Address - Fax:408-366-1326
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA471631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice