Provider Demographics
NPI:1902055536
Name:RAMACHANDRAN, NIRMALA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NIRMALA
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:673 WEST JARDIN TERRACE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOUSE
Mailing Address - State:CA
Mailing Address - Zip Code:95391
Mailing Address - Country:US
Mailing Address - Phone:408-829-7234
Mailing Address - Fax:
Practice Address - Street 1:673 WEST JARDIN TERRACE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOUSE
Practice Address - State:CA
Practice Address - Zip Code:95391
Practice Address - Country:US
Practice Address - Phone:408-829-7234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA571551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice