Provider Demographics
NPI:1013139500
Name:FEIMSTER, TAWANA DENISE (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TAWANA
Middle Name:DENISE
Last Name:FEIMSTER
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:775 ADDISON DR STE 111
Mailing Address - Street 2:
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29730-7061
Mailing Address - Country:US
Mailing Address - Phone:980-316-7109
Mailing Address - Fax:980-939-0170
Practice Address - Street 1:775 ADDISON DR STE 111
Practice Address - Street 2:
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-7061
Practice Address - Country:US
Practice Address - Phone:980-316-7109
Practice Address - Fax:980-939-0170
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-03
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD138511223E0200X
VA04014128571223E0200X
TX308331223E0200X
SC103251223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodontics