Provider Demographics
NPI:1306285879
Name:DATIEN, NATALIE E (DDS)
Entity type:Individual
Prefix:DR
First Name:NATALIE
Middle Name:E
Last Name:DATIEN
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 1:509 CAROLINE CIR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-4553
Mailing Address - Country:US
Mailing Address - Phone:734-657-2611
Mailing Address - Fax:
Practice Address - Street 1:11600 BUSY ST STE 101
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-4066
Practice Address - Country:US
Practice Address - Phone:804-215-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-18
Last Update Date:2025-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014179361223P0221X
OH30.0240021223P0221X
MI29010209051223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty