Provider Demographics
NPI:1922165554
Name:NIKOLAEFF, NATALIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATALIA
Middle Name:
Last Name:NIKOLAEFF
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:NATALIA
Other - Middle Name:
Other - Last Name:NIKOLAEFF-SVENSSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:4214 CALIFORNIA ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-1314
Mailing Address - Country:US
Mailing Address - Phone:415-752-0844
Mailing Address - Fax:
Practice Address - Street 1:4214 CALIFORNIA ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-1314
Practice Address - Country:US
Practice Address - Phone:415-752-0844
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27047122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB27047-01OtherDENTI-CAL