Nathalie Cristina Astudillo, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13866 Issued in MN

Practice address

2442 County Hwy 10
Mounds View, MN 55112

Phone

(763) 316-5400

NPI assigned

Jun 27, 2017

Last updated

Jun 27, 2017By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1498521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1498521600000",
    "number": "1700306149",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 FREMONT AVE S APT 204",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554081120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2442 COUNTY HWY 10",
            "city": "MOUNDS VIEW",
            "state": "MN",
            "postal_code": "55112",
            "telephone_number": "763-316-5400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASTUDILLO",
        "first_name": "NATHALIE",
        "middle_name": "CRISTINA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-06-27",
        "last_updated": "2017-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13866",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Advantage Therapeutics
• Apple Tree Dental
• Axis Minnesota, Inc.
• Nathan Buck, DC
• Shana Marie Buerck, LDH, DT
• Crosstown Drug
• Rebecca Louise Dewolf Felices, DMD

• Dentist in Mounds View, MN
• Providers in Mounds View, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.