1821519513 NPI number — DR. NATALIE BARBARA DOWNS MONETTE DDS

Table of content: DR. NATALIE BARBARA DOWNS MONETTE DDS (NPI 1821519513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821519513 NPI number — DR. NATALIE BARBARA DOWNS MONETTE DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONETTE
Provider First Name:
NATALIE
Provider Middle Name:
BARBARA DOWNS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DOWNS
Provider Other First Name:
NATALIE
Provider Other Middle Name:
BARBARA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DDS
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1821519513
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/01/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2757 LEONARD ST NE
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
GRAND RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49525
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-940-0481
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2757 LEONARD ST NE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
GRAND RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49525
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
616-940-0481
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/03/2017

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  2901022382 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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