Provider Demographics
NPI:1477574960
Name:WEINFELD, JEFFREY L (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:L
Last Name:WEINFELD
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 1:6024 W MAPLE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4405
Mailing Address - Country:US
Mailing Address - Phone:248-661-2222
Mailing Address - Fax:248-661-3128
Practice Address - Street 1:6024 W MAPLE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4405
Practice Address - Country:US
Practice Address - Phone:248-661-2222
Practice Address - Fax:248-661-3128
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-21
Last Update Date:2008-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010128601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice