1891093779 NPI number — DR. NATASHA EILEEN CRESPO D.D.S.

Table of content: DR. LOUISE KARGER MD (NPI 1245202522)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891093779 NPI number — DR. NATASHA EILEEN CRESPO D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRESPO
Provider First Name:
NATASHA
Provider Middle Name:
EILEEN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.D.S.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1891093779
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2758 N GALLOWAY AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MESQUITE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75150-6381
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
722-895-5639
Provider Business Mailing Address Fax Number:
972-329-5039

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3626 N MACARTHUR BLVD
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
IRVING
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75062-3643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
972-594-0022
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2011

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: 122300000X , with the licence number:  25389 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com