Provider Demographics
NPI:1396030797
Name:PIERRE-LOUIS, NATASHA (DMD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:PIERRE-LOUIS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:JEAN-CHARLES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:114 OSBORNE RD
Mailing Address - Street 2:
Mailing Address - City:WEST HEMPSTEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11552-1345
Mailing Address - Country:US
Mailing Address - Phone:516-652-4420
Mailing Address - Fax:
Practice Address - Street 1:682 UNION AVE
Practice Address - Street 2:
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-3552
Practice Address - Country:US
Practice Address - Phone:516-876-6302
Practice Address - Fax:516-876-0521
Is Sole Proprietor?:No
Enumeration Date:2011-06-14
Last Update Date:2019-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY05651911223G0001X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program