Provider Demographics
NPI:1184700528
Name:FEIGELSON, STEVEN RUSS (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RUSS
Last Name:FEIGELSON
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 1:69 VETERANS MEMORIAL HWY
Mailing Address - Street 2:
Mailing Address - City:COMMACK
Mailing Address - State:NY
Mailing Address - Zip Code:11725-3452
Mailing Address - Country:US
Mailing Address - Phone:631-462-1470
Mailing Address - Fax:631-462-1420
Practice Address - Street 1:69 VETERANS MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-3452
Practice Address - Country:US
Practice Address - Phone:631-462-1470
Practice Address - Fax:631-462-1420
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0429461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice