Provider Demographics
NPI:1003221540
Name:FENG, CONNIE X (DDS)
Entity Type:Individual
Prefix:DR
First Name:CONNIE
Middle Name:X
Last Name:FENG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2011 GREYHAWK PL
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-9312
Mailing Address - Country:US
Mailing Address - Phone:919-260-0848
Mailing Address - Fax:
Practice Address - Street 1:9776 HOLLY SPRINGS RD
Practice Address - Street 2:
Practice Address - City:APEX
Practice Address - State:NC
Practice Address - Zip Code:27539
Practice Address - Country:US
Practice Address - Phone:919-863-3933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-24
Last Update Date:2017-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9797122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist