Provider Demographics
NPI:1679063804
Name:ANDREA L FELEPPELLE DDS LLC
Entity Type:Organization
Organization Name:ANDREA L FELEPPELLE DDS LLC
Other - Org Name:BRECKSVILLE FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FELEPPELLE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-526-8688
Mailing Address - Street 1:8871 BRECKSVILLE RD STE A
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-1921
Mailing Address - Country:US
Mailing Address - Phone:440-526-8688
Mailing Address - Fax:440-526-0378
Practice Address - Street 1:8871 BRECKSVILLE RD STE A
Practice Address - Street 2:
Practice Address - City:BRECKSVILLE
Practice Address - State:OH
Practice Address - Zip Code:44141-1921
Practice Address - Country:US
Practice Address - Phone:440-526-8688
Practice Address - Fax:440-526-0378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-14
Last Update Date:2018-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK30.024127122300000X
OH30.0241271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty