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General NPI Number Information
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NPI Number | 1174149363
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Entity Type | Individual
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Provider Name | NATALIYA PAVLOVNA JUMONVILLE DMD
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Gender | Female
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Dates
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Enumeration Date | 06/23/2020
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Last Update Date | 03/22/2023
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Provider Practice Location Address
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Address Line | 4921 E BELL RD STE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6002
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Country | US
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Telephone | 602-996-2690
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Fax | 602-996-4130
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Provider Business Mailing Address
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Address Line | 4921 E BELL RD STE 108
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-6002
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Country | US
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Telephone | 602-996-2690
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Fax | 602-996-4130
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 7107
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | D011045
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License Number State | AZ
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