Provider Demographics
NPI:1144637331
Name:FEINMAN, DARA NICOLE (DMD)
Entity type:Individual
Prefix:DR
First Name:DARA
Middle Name:NICOLE
Last Name:FEINMAN
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 1:4545 W BEARDSLEY RD
Mailing Address - Street 2:APT 2091
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-5014
Mailing Address - Country:US
Mailing Address - Phone:201-788-5623
Mailing Address - Fax:
Practice Address - Street 1:1820 W THUNDERBIRD RD STE 1
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85023-6300
Practice Address - Country:US
Practice Address - Phone:602-993-6080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-19
Last Update Date:2014-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD009019122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist