Healthcare Provider Details

I. General information

NPI: 1639146517
Provider Name (Legal Business Name): NATANYA LILLIAN MARRACINO BROWN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2006
Last Update Date: 05/08/2026
Certification Date: 05/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1144 SONOMA AVE STE 119
SANTA ROSA CA
95405-4812
US

IV. Provider business mailing address

440 N BARRANCA AVE # 6743
COVINA CA
91723-1722
US

V. Phone/Fax

Practice location:
  • Phone: 707-527-9170
  • Fax:
Mailing address:
  • Phone: 415-617-9901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number58169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: