Provider Demographics
NPI:1639608441
Name:GROVER, NATASHA AMY (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:AMY
Last Name:GROVER
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 1:2320 COMMONWEALTH DR
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22901-1622
Mailing Address - Country:US
Mailing Address - Phone:703-732-5099
Mailing Address - Fax:
Practice Address - Street 1:2320 COMMONWEALTH DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22901-1622
Practice Address - Country:US
Practice Address - Phone:434-978-1510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-06
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401415656122300000X, 1223G0001X
VA04015156561223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health