Individual provider Active NPI

Courtney Naten, D.D.S.

  • General Practice Dentistry
  • Elk Grove, CA
National Provider Identifier
1104176502
Registry record updated Sep 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
61842 Issued in CA
Practice address
8880 Elk Grove Blvd
Elk Grove, CA 95624
Phone
(916) 685-2141
NPI assigned
Sep 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 61842 CA Primary

Addresses

Primary practice location

8880 Elk Grove Blvd
Elk Grove, CA 95624

Mailing address

8880 Elk Grove Blvd
Elk Grove, CA 95624

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
61842CAMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1347408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1347408000000",
    "number": "1104176502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8880 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95624"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8880 ELK GROVE BLVD",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "95624",
            "telephone_number": "916-685-2141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NATEN",
        "first_name": "COURTNEY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-12",
        "last_updated": "2012-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "61842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elk Grove, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.