Individual provider Active NPI

Natasa Urukalo-Harshman, D.D.S.

  • General Practice Dentistry
  • Grand Rapids, MI
National Provider Identifier
1609920040
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901017692 Issued in MI
Practice address
976 3 Mile Rd NW Ste a
Grand Rapids, MI 49544-8203
Phone
(616) 784-4038
Fax
(616) 785-9501
NPI assigned
Jan 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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 2901017692 MI Primary

Addresses

Primary practice location

976 3 Mile Rd NW Ste a
Grand Rapids, MI 49544-8203

Mailing address

976 3 Mile Rd NW Ste a
Grand Rapids, MI 49544-8203
Phone (616) 784-4038

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20160113002298 MI Order and Referring Only - DentistPractitioner - Dentist 5799087342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901017692MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
3 Mile Family Dentistry, PLLC CurrentSince Jul 21, 2024 Accepting new patients
Durham & Mehling DDS PC PastSince Nov 8, 2015 Accepting new patients

Locations

976 3 Mile Rd NW
Ste A
Grand Rapids, MI 49544
Phone (616) 784-4038

Organizations & group practices 2

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": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721174400000",
    "number": "1609920040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "976 3 MILE RD NW STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448203",
            "telephone_number": "616-784-4038",
            "fax_number": "616-785-9501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "976 3 MILE RD NW STE A",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495448203",
            "telephone_number": "616-784-4038",
            "fax_number": "616-785-9501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "URUKALO-HARSHMAN",
        "first_name": "NATASA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2024-07-17",
        "certification_date": "2024-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901017692",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

Verify at the official NPI Registry.