1982132049 NPI number — NATALIA ALICIA YALDOO DDS

Table of content: NATALIA ALICIA YALDOO DDS (NPI 1982132049)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982132049 NPI number — NATALIA ALICIA YALDOO DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YALDOO
Provider First Name:
NATALIA
Provider Middle Name:
ALICIA
Provider Name Prefix Text:
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:
RADZIKOWSKI
Provider Other First Name:
NATALIA
Provider Other Middle Name:
ALICIA
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:
1982132049
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
783 ARTHURS CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARPON SPRINGS
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34689-2871
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
616-885-8713
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2323 CURLEW RD STE 2F
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DUNEDIN
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
34698-9331
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
727-785-2467
Provider Business Practice Location Address Fax Number:
727-785-3748
Provider Enumeration Date:
06/01/2017

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: 122300000X , with the licence number:  2901022212 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: DN26728 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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