Provider Demographics
NPI:1548840085
Name:RAMDHAN, SUSAN RIA (DMD)
Entity type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:RIA
Last Name:RAMDHAN
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 1:231 PINARD COURT
Mailing Address - Street 2:
Mailing Address - City:SAN FERNANDO
Mailing Address - State:VICTORIA
Mailing Address - Zip Code:00000
Mailing Address - Country:TT
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:231 PINARD COURT
Practice Address - Street 2:
Practice Address - City:SAN FERNANDO
Practice Address - State:VICTORIA
Practice Address - Zip Code:00000
Practice Address - Country:TT
Practice Address - Phone:868-741-5528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-09
Last Update Date:2021-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL21487122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist