Provider Demographics
NPI:1881895472
Name:ESSENFELD, ELIOT S (DDS)
Entity type:Individual
Prefix:
First Name:ELIOT
Middle Name:S
Last Name:ESSENFELD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ELIOT
Other - Middle Name:S
Other - Last Name:ESSENFELD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:53 OLD KINGS HIGHWAY NORTH
Mailing Address - Street 2:
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820
Mailing Address - Country:US
Mailing Address - Phone:203-655-8887
Mailing Address - Fax:203-655-0524
Practice Address - Street 1:53 OLD KINGS HIGHWAY NORTH
Practice Address - Street 2:
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820
Practice Address - Country:US
Practice Address - Phone:203-655-8887
Practice Address - Fax:203-655-0524
Is Sole Proprietor?:No
Enumeration Date:2007-05-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7612 CT1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice