Provider Demographics
NPI:1669495024
Name:BARRY A. FELDMAN, D.D.S., P.C.
Entity Type:Organization
Organization Name:BARRY A. FELDMAN, D.D.S., P.C.
Other - Org Name:FELDMAN ORTHODONTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:BARRY
Authorized Official - Middle Name:A
Authorized Official - Last Name:FELDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-272-0900
Mailing Address - Street 1:350 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3160
Mailing Address - Country:US
Mailing Address - Phone:203-272-0900
Mailing Address - Fax:203-271-2300
Practice Address - Street 1:350 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3160
Practice Address - Country:US
Practice Address - Phone:203-272-0900
Practice Address - Fax:203-271-2300
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT38211223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty