Provider Demographics
NPI:1790211761
Name:FELDMAN, STEVEN GREGORY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GREGORY
Last Name:FELDMAN
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 1:4707 CONNECTICUT AVENUE, NW
Mailing Address - Street 2:SUITE 108
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-5619
Mailing Address - Country:US
Mailing Address - Phone:240-599-6050
Mailing Address - Fax:
Practice Address - Street 1:4707 CONNECTICUT AVENUE, NW
Practice Address - Street 2:SUITE 108
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5619
Practice Address - Country:US
Practice Address - Phone:240-599-6050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCDEN1001892122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist