Provider Demographics
NPI:1265589121
Name:FELDMAN, SETH (DDS)
Entity type:Individual
Prefix:
First Name:SETH
Middle Name:
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 1:313 PARK AVE
Mailing Address - Street 2:SUITE G1
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3327
Mailing Address - Country:US
Mailing Address - Phone:703-534-3730
Mailing Address - Fax:703-534-3751
Practice Address - Street 1:313 PARK AVE
Practice Address - Street 2:SUITE G1
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046-3327
Practice Address - Country:US
Practice Address - Phone:703-534-3730
Practice Address - Fax:703-534-3751
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2017-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014113751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics