Healthcare Provider Details

I. General information

NPI: 1427410158
Provider Name (Legal Business Name): NATALIE MCCRACKIN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/22/2016
Last Update Date: 09/15/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7060 DOUGLAS BLVD
GRANITE BAY CA
95746-6250
US

IV. Provider business mailing address

7060 DOUGLAS BLVD
GRANITE BAY CA
95746-6250
US

V. Phone/Fax

Practice location:
  • Phone: 916-735-4720
  • Fax:
Mailing address:
  • Phone: 916-735-4720
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number101183
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: