Provider Demographics
NPI:1396238226
Name:COURINGTON, NATHALIE G (DMD)
Entity type:Individual
Prefix:MRS
First Name:NATHALIE
Middle Name:G
Last Name:COURINGTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:NATHALIE
Other - Middle Name:M
Other - Last Name:GOMEZ LEON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:210 FIELDSTOWN RD STE 120
Mailing Address - Street 2:
Mailing Address - City:GARDENDALE
Mailing Address - State:AL
Mailing Address - Zip Code:35071-2418
Mailing Address - Country:US
Mailing Address - Phone:205-418-1069
Mailing Address - Fax:
Practice Address - Street 1:210 FIELDSTOWN RD STE 120
Practice Address - Street 2:
Practice Address - City:GARDENDALE
Practice Address - State:AL
Practice Address - Zip Code:35071-2418
Practice Address - Country:US
Practice Address - Phone:205-418-1069
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-14
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL65041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice