Provider Demographics
NPI:1982132049
Name:YALDOO, NATALIA ALICIA (DDS)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:ALICIA
Last Name:YALDOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NATALIA
Other - Middle Name:ALICIA
Other - Last Name:RADZIKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:783 ARTHURS CT
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2871
Mailing Address - Country:US
Mailing Address - Phone:616-885-8713
Mailing Address - Fax:
Practice Address - Street 1:2323 CURLEW RD STE 2F
Practice Address - Street 2:
Practice Address - City:DUNEDIN
Practice Address - State:FL
Practice Address - Zip Code:34698-9331
Practice Address - Country:US
Practice Address - Phone:727-785-2467
Practice Address - Fax:727-785-3748
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901022212122300000X
FLDN267281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist