Provider Demographics
NPI:1639734494
Name:FENIGSTEIN, DORIS (DDS)
Entity Type:Individual
Prefix:
First Name:DORIS
Middle Name:
Last Name:FENIGSTEIN
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 1:221 N MAIN ST APT 310
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-4138
Mailing Address - Country:US
Mailing Address - Phone:914-755-7404
Mailing Address - Fax:
Practice Address - Street 1:28626 TELEGRAPH RD
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48034-1934
Practice Address - Country:US
Practice Address - Phone:248-988-3676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT12821122300000X
MI2901601205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist