Provider Demographics
NPI:1164957429
Name:STARKLE, NATALYA (DDS)
Entity Type:Individual
Prefix:
First Name:NATALYA
Middle Name:
Last Name:STARKLE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NATALYA
Other - Middle Name:
Other - Last Name:DUNAEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:777 BANNOCK ST
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80204-4597
Mailing Address - Country:US
Mailing Address - Phone:202-264-2302
Mailing Address - Fax:
Practice Address - Street 1:6401 S RICHARDS AVE
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87508-4887
Practice Address - Country:US
Practice Address - Phone:505-984-5048
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CODEN.00203562122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program