Provider Demographics
NPI:1376034462
Name:HARIRI, NATALIA C (DMD)
Entity Type:Individual
Prefix:
First Name:NATALIA
Middle Name:C
Last Name:HARIRI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20948 N 90TH AVE
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85382-6468
Mailing Address - Country:US
Mailing Address - Phone:623-285-4285
Mailing Address - Fax:
Practice Address - Street 1:7777 W DEER VALLEY RD STE 160
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85382-2104
Practice Address - Country:US
Practice Address - Phone:623-285-4285
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-23
Last Update Date:2018-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0100091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice