Provider Demographics
NPI:1669220224
Name:VLACHOS AND FEAGIN ORTHODONTICS, P. C.
Entity type:Organization
Organization Name:VLACHOS AND FEAGIN ORTHODONTICS, P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:FEAGIN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD, MS
Authorized Official - Phone:205-871-5557
Mailing Address - Street 1:3045 INDEPENDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:AL
Mailing Address - Zip Code:35209-4169
Mailing Address - Country:US
Mailing Address - Phone:205-871-5557
Mailing Address - Fax:205-414-1930
Practice Address - Street 1:3045 INDEPENDENCE DR
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:AL
Practice Address - Zip Code:35209-4169
Practice Address - Country:US
Practice Address - Phone:205-871-5557
Practice Address - Fax:205-414-1930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty