Provider Demographics
NPI:1639139736
Name:BELJAJEV, NATALIJA SIMOVIC (DDS)
Entity Type:Individual
Prefix:MRS
First Name:NATALIJA
Middle Name:SIMOVIC
Last Name:BELJAJEV
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NATALIJA
Other - Middle Name:
Other - Last Name:BELJAJEV
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4770 N LINCOLN AVE
Mailing Address - Street 2:STE 12
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60625-2092
Mailing Address - Country:US
Mailing Address - Phone:773-275-5548
Mailing Address - Fax:773-275-7322
Practice Address - Street 1:4770 N LINCOLN AVE
Practice Address - Street 2:STE 12
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60625-2092
Practice Address - Country:US
Practice Address - Phone:773-275-5548
Practice Address - Fax:773-275-7322
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice