Provider Demographics
NPI:1669800439
Name:UMOF, NATALIE (DDS)
Entity type:Individual
Prefix:
First Name:NATALIE
Middle Name:
Last Name:UMOF
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 1:217 E OAK AVE
Mailing Address - Street 2:#1
Mailing Address - City:EL SEGUNDO
Mailing Address - State:CA
Mailing Address - Zip Code:90245-2368
Mailing Address - Country:US
Mailing Address - Phone:310-903-3006
Mailing Address - Fax:
Practice Address - Street 1:451 MANHATTAN BEACH BLVD
Practice Address - Street 2:#D226
Practice Address - City:MANHATTAN BEACH
Practice Address - State:CA
Practice Address - Zip Code:90266-5345
Practice Address - Country:US
Practice Address - Phone:310-545-5757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-14
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627241223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry