Provider Demographics
NPI:1134112568
Name:NEBBLETT, NATALIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:
Last Name:NEBBLETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:977 LIVINGSTON AVE
Mailing Address - Street 2:DENTAL HEALTH ASSOC
Mailing Address - City:NORTH BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08902-1843
Mailing Address - Country:US
Mailing Address - Phone:732-418-9800
Mailing Address - Fax:
Practice Address - Street 1:977 LIVINGSTON AVE
Practice Address - Street 2:DENTAL HEALTH ASSOC
Practice Address - City:NORTH BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08902-1843
Practice Address - Country:US
Practice Address - Phone:732-418-9800
Practice Address - Fax:732-418-0048
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2017-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1022721001223G0001X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
298962186OtherSOCIAL SECURITY NUMBER