Provider Demographics
NPI:1174744338
Name:GHIZ, RONALD S (DDS)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:S
Last Name:GHIZ
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 1:488 MADISON AVENUE
Mailing Address - Street 2:SUITE 1712
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-5709
Mailing Address - Country:US
Mailing Address - Phone:212-759-9797
Mailing Address - Fax:212-759-9262
Practice Address - Street 1:488 MADISON AVENUE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-5709
Practice Address - Country:US
Practice Address - Phone:212-759-9797
Practice Address - Fax:212-759-9262
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY029177122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist