Provider Demographics
NPI:1407972433
Name:FELSENFELD, ALAN L (DDS)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:L
Last Name:FELSENFELD
Suffix:
Gender:M
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:UCLA SCHOOL OF DENTISTRY, 53-076
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095
Mailing Address - Country:US
Mailing Address - Phone:310-825-9733
Mailing Address - Fax:310-794-1873
Practice Address - Street 1:53-076 UCLA SCHOOL OF DENTISTRY
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-825-9733
Practice Address - Fax:310-794-1873
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2013-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA245451223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWD24545DMedicare PIN
CATH 7216Medicare UPIN