Provider Demographics
NPI:1770646341
Name:FIENMAN, ADAM I (DDS)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:I
Last Name:FIENMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6400 VILLAGE PARK DR
Mailing Address - Street 2:APT 201
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2158
Mailing Address - Country:US
Mailing Address - Phone:248-757-2855
Mailing Address - Fax:
Practice Address - Street 1:8984 E 13 MILE RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-2206
Practice Address - Country:US
Practice Address - Phone:586-573-9890
Practice Address - Fax:586-573-2628
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010191571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice