Provider Demographics
NPI:1467175315
Name:NATOUF, FATIMA (DDS)
Entity Type:Individual
Prefix:DR
First Name:FATIMA
Middle Name:
Last Name:NATOUF
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 1:6463 BELL POINTE
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77706-2590
Mailing Address - Country:US
Mailing Address - Phone:510-325-3227
Mailing Address - Fax:
Practice Address - Street 1:860 S 11TH ST STE 101
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77701-3737
Practice Address - Country:US
Practice Address - Phone:409-240-2990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX39053122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAD8388732Medicaid