Provider Demographics
NPI:1265597603
Name:WEISENFELD, LINDA C (DMD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:C
Last Name:WEISENFELD
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:169 MERRITT DR
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1822
Mailing Address - Country:US
Mailing Address - Phone:201-501-0813
Mailing Address - Fax:201-501-8921
Practice Address - Street 1:169 MERRITT DR
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1822
Practice Address - Country:US
Practice Address - Phone:201-501-0813
Practice Address - Fax:201-501-8921
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1013751001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics