Provider Demographics
NPI:1790855583
Name:FELDMAN, VIOLET (DDS)
Entity Type:Individual
Prefix:DR
First Name:VIOLET
Middle Name:
Last Name:FELDMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3400 DEL LAGO BLVD
Mailing Address - Street 2:STE C
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92029-7427
Mailing Address - Country:US
Mailing Address - Phone:760-746-8777
Mailing Address - Fax:
Practice Address - Street 1:4511 CAMPOBELLO ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-2715
Practice Address - Country:US
Practice Address - Phone:858-231-4889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2017-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA505661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice