Provider Demographics
NPI:1356835896
Name:FEINGOLD, JENNIFER BRITTANY (DDS)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:BRITTANY
Last Name:FEINGOLD
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 1:2761 OAKDALE BLVD STE 4
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9754
Mailing Address - Country:US
Mailing Address - Phone:193-626-5437
Mailing Address - Fax:
Practice Address - Street 1:2761 OAKDALE BLVD STE 4
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-9754
Practice Address - Country:US
Practice Address - Phone:319-626-5437
Practice Address - Fax:319-626-2301
Is Sole Proprietor?:No
Enumeration Date:2018-06-19
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA09572390200000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program