Provider Demographics
NPI:1093358525
Name:NATALYA CARMICHAEL DDS, INC
Entity Type:Organization
Organization Name:NATALYA CARMICHAEL DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALYA
Authorized Official - Middle Name:
Authorized Official - Last Name:CARMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-893-0803
Mailing Address - Street 1:9728 CARMEL MOUNTAIN RD STE B
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92129-2849
Mailing Address - Country:US
Mailing Address - Phone:858-484-2560
Mailing Address - Fax:858-484-2597
Practice Address - Street 1:9728 CARMEL MOUNTAIN RD STE B
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92129-2849
Practice Address - Country:US
Practice Address - Phone:858-484-2560
Practice Address - Fax:858-484-2597
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATALYA CARMICHAEL DDS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-10-28
Last Update Date:2019-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty