Individual provider Active NPI

Nataliya Pavlovna Jumonville, DMD

  • General Practice Dentistry
  • Scottsdale, AZ
National Provider Identifier
1174149363
Registry record updated Mar 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D011045 Issued in AZ
Practice address
4921 E Bell Rd Ste 108
Scottsdale, AZ 85254-6002
Phone
(602) 996-2690
Fax
(602) 996-4130
NPI assigned
Jun 23, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7107 LA
General Practice Dentistry 1223G0001X D011045 AZ Primary

Addresses

Primary practice location

4921 E Bell Rd Ste 108
Scottsdale, AZ 85254-6002

Mailing address

4921 E Bell Rd Ste 108
Scottsdale, AZ 85254-6002
Phone (602) 996-2690

Other practice location 1

1708 Mlk Jr Blvd Ste 101
Houma, LA 70360-2408
Phone (985) 746-9886

Other practice location 2

2240 Veterans Memorial Blvd
Kenner, LA 70062-5673
Phone (504) 666-9518

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
7107LAMDSocial Worker
D011045AZMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nataliya Jumonville DMD, PLLC General Practice Current Accepting new patients

Locations

4921 E Bell Rd
Ste 108
Scottsdale, AZ 85254
Phone (602) 867-0111

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679443200000",
    "number": "1174149363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4921 E BELL RD STE 108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546002",
            "telephone_number": "602-996-2690",
            "fax_number": "602-996-4130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4921 E BELL RD STE 108",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852546002",
            "telephone_number": "602-996-2690",
            "fax_number": "602-996-4130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1708 Mlk Jr Blvd Ste 101",
            "address_purpose": "LOCATION",
            "city": "Houma",
            "state": "LA",
            "postal_code": "703602408",
            "country_code": "US",
            "telephone_number": "985-746-9886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2240 Veterans Memorial Blvd",
            "address_purpose": "LOCATION",
            "city": "Kenner",
            "state": "LA",
            "postal_code": "700625673",
            "country_code": "US",
            "telephone_number": "504-666-9518",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUMONVILLE",
        "first_name": "NATALIYA",
        "middle_name": "PAVLOVNA",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-23",
        "last_updated": "2023-03-22",
        "certification_date": "2023-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "7107",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D011045",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2023; 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.