Provider Demographics
NPI:1144373721
Name:DEBORAH FINEGOLD D.D.S., INC.
Entity type:Organization
Organization Name:DEBORAH FINEGOLD D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:FINEGOLD
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:559-896-3145
Mailing Address - Street 1:1219 ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:CA
Mailing Address - Zip Code:93662-3227
Mailing Address - Country:US
Mailing Address - Phone:559-896-3145
Mailing Address - Fax:559-896-7042
Practice Address - Street 1:1219 ROSE AVE
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:CA
Practice Address - Zip Code:93662-3227
Practice Address - Country:US
Practice Address - Phone:559-896-3145
Practice Address - Fax:559-896-7042
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA38186261QS0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QS0112XAmbulatory Health Care FacilitiesClinic/CenterOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU60000Medicare ID - Type Unspecified