Provider Demographics
NPI:1295926285
Name:MAXIMO J RAMOS JR DMD PC
Entity type:Organization
Organization Name:MAXIMO J RAMOS JR DMD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAXIMO
Authorized Official - Middle Name:JUNIO
Authorized Official - Last Name:RAMOS
Authorized Official - Suffix:JR
Authorized Official - Credentials:DMD PC
Authorized Official - Phone:718-743-7755
Mailing Address - Street 1:PO BOX 770638
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-0638
Mailing Address - Country:US
Mailing Address - Phone:718-743-7755
Mailing Address - Fax:718-743-7756
Practice Address - Street 1:2375 OCEAN AVE
Practice Address - Street 2:CORNER AVE S APT 1F
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3527
Practice Address - Country:US
Practice Address - Phone:718-743-7755
Practice Address - Fax:718-743-7756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY042612122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01174258Medicaid