Provider Demographics
NPI:1174716880
Name:RAMTIN, PARHAM (DDS)
Entity type:Individual
Prefix:DR
First Name:PARHAM
Middle Name:
Last Name:RAMTIN
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 1:13564 VAN NUYS BLVD
Mailing Address - Street 2:
Mailing Address - City:PACOIMA
Mailing Address - State:CA
Mailing Address - Zip Code:91331-3054
Mailing Address - Country:US
Mailing Address - Phone:818-897-5771
Mailing Address - Fax:818-897-5761
Practice Address - Street 1:13564 VAN NUYS BLVD
Practice Address - Street 2:
Practice Address - City:PACOIMA
Practice Address - State:CA
Practice Address - Zip Code:91331-3054
Practice Address - Country:US
Practice Address - Phone:818-897-5771
Practice Address - Fax:818-897-5761
Is Sole Proprietor?:No
Enumeration Date:2007-08-26
Last Update Date:2022-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA560491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice