Provider Demographics
NPI:1760548044
Name:RICHARD E FELDHAKE DMD AND ASSOCIATED PC
Entity Type:Organization
Organization Name:RICHARD E FELDHAKE DMD AND ASSOCIATED PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:ENGLISH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-931-8898
Mailing Address - Street 1:7725 N 43RD AVE
Mailing Address - Street 2:SUITE 711
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85051-5770
Mailing Address - Country:US
Mailing Address - Phone:623-931-8898
Mailing Address - Fax:623-930-1182
Practice Address - Street 1:7725 N 43RD AVE
Practice Address - Street 2:SUITE 711
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5770
Practice Address - Country:US
Practice Address - Phone:623-931-8898
Practice Address - Fax:623-930-1182
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty