Provider Demographics
NPI:1801887146
Name:FELIX, AISEL L (DDS)
Entity type:Individual
Prefix:
First Name:AISEL
Middle Name:L
Last Name:FELIX
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 HARTWELL PL
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-1222
Mailing Address - Country:US
Mailing Address - Phone:917-292-9317
Mailing Address - Fax:
Practice Address - Street 1:9320A ROOSEVELT AVE
Practice Address - Street 2:
Practice Address - City:JACKSON HTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7944
Practice Address - Country:US
Practice Address - Phone:718-396-6009
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04766811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice