Individual provider Active NPI

Natalie Ruth Heaivilin, D.D.S.

  • General Practice Dentistry
  • Ann Arbor, MI
National Provider Identifier
1457774184
Registry record updated Nov 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901601122 Issued in MI
Practice address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone
(734) 936-5950
NPI assigned
Jan 31, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 9, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 0401416320 VA
General Practice Dentistry 1223G0001X 63326 CA
General Practice Dentistry 1223G0001X 2901601122 MI Primary

Addresses

Primary practice location

1011 N University Ave
Ann Arbor, MI 48109-1078

Mailing address

3515 Larchmont Dr
Ann Arbor, MI 48105-2853
Phone (913) 593-5842

Other practice location 1

707 Parnassus Ave
D1201
San Francisco, CA 94143-2210
Phone (415) 502-8914

Other practice location 2

6677 Richmond Hwy
Alexandria, VA 22306-6647
Phone (703) 535-5568

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://dent.umich.edu/ Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160610000602 CA Practitioner - Oral Surgery 5193015782 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0401416320VAMDDentist
2901601122MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
UCSF Oral Medicine Clinic General Practice CurrentSince Apr 24, 2016 Accepting new patients

Locations

513 Parnassus Ave
San Francisco, CA 94143
Phone (415) 476-1239

707 Parnassus Ave
#D1201
San Francisco, CA 94143
Phone (415) 476-1316

513 Parnassus Ave
Rm S722
San Francisco, CA 94143
Phone (415) 476-2045

1975 4th St
San Francisco, CA 94143
Phone (415) 353-3000

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1391126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636416000000",
    "number": "1457774184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 LARCHMONT DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481052853",
            "telephone_number": "913-593-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1011 N UNIVERSITY AVE",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481091078",
            "telephone_number": "734-936-5950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "707 Parnassus Ave",
            "address_2": "D1201",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941432210",
            "country_code": "US",
            "telephone_number": "415-502-8914",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "6677 Richmond Hwy",
            "address_purpose": "LOCATION",
            "city": "Alexandria",
            "state": "VA",
            "postal_code": "223066647",
            "country_code": "US",
            "telephone_number": "703-535-5568",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEAIVILIN",
        "first_name": "NATALIE",
        "middle_name": "RUTH",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-01-31",
        "last_updated": "2021-11-09",
        "certification_date": "2021-11-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401416320",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63326",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901601122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://dent.umich.edu/",
            "affiliation": "N",
            "endpointDescription": "Hospital Dentistry Program",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1011 N University Ave",
            "city": "Ann Arbor",
            "state": "MI",
            "country_code": "US",
            "postal_code": "481091078",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Ann Arbor, MI

Sources for this page

Verify at the official NPI Registry.