Provider Demographics
NPI:1609372440
Name:TAWANA FEIMSTER, DDS, MS, PLLC
Entity Type:Organization
Organization Name:TAWANA FEIMSTER, DDS, MS, PLLC
Other - Org Name:TRANQUILITY DENTAL SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAWANA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FEIMSTER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:571-989-8634
Mailing Address - Street 1:775 ADDISON DR STE 111
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7061
Mailing Address - Country:US
Mailing Address - Phone:980-316-7109
Mailing Address - Fax:980-939-0170
Practice Address - Street 1:775 ADDISON DR STE 111
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7061
Practice Address - Country:US
Practice Address - Phone:980-316-7109
Practice Address - Fax:980-939-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-02
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX308331223E0200X
261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Multi-Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Multi-Specialty