Provider Demographics
NPI:1871088971
Name:NAZARI, RAMAN EMANUEL (DDS)
Entity type:Individual
Prefix:DR
First Name:RAMAN
Middle Name:EMANUEL
Last Name:NAZARI
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 1:1574 SUNNYVALE AVE APT 35
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94597-1929
Mailing Address - Country:US
Mailing Address - Phone:408-599-8029
Mailing Address - Fax:
Practice Address - Street 1:1670 HILLSDALE AVE STE 20
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95124-3241
Practice Address - Country:US
Practice Address - Phone:408-377-3214
Practice Address - Fax:408-377-3288
Is Sole Proprietor?:No
Enumeration Date:2018-06-30
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS102627122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty