Individual provider Active NPI

Natalia Jateal Hardgrave, DDS

  • Dentist
  • Springdale, AR
National Provider Identifier
1902557176
Registry record updated Jan 10, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4561 Issued in AR
Practice address
4870 Elm Springs Rd Ste B
Springdale, AR 72762-3749
Phone
(479) 306-7484
NPI assigned
Jan 10, 2022
Last updated
Jan 10, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4561 AR Primary

Addresses

Primary practice location

4870 Elm Springs Rd Ste B
Springdale, AR 72762-3749

Mailing address

1203 Cliffstone St # 1
Bentonville, AR 72712-8461
Phone (479) 774-4495

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
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
I20220907001602 AR Order and Referring Only - DentistPractitioner - Dentist 5597149732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1641772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1902557176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 CLIFFSTONE ST # 1",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727128461",
            "telephone_number": "479-774-4495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 ELM SPRINGS RD STE B",
            "city": "SPRINGDALE",
            "state": "AR",
            "postal_code": "727623749",
            "telephone_number": "479-306-7484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARDGRAVE",
        "first_name": "NATALIA",
        "middle_name": "JATEAL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-10",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "4561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Springdale, AR

Sources for this page

Verify at the official NPI Registry.