Provider Demographics
NPI:1861533663
Name:LEW-FEIT, JENNA FAYE (DMD)
Entity type:Individual
Prefix:DR
First Name:JENNA
Middle Name:FAYE
Last Name:LEW-FEIT
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 1:443 N NEW BALLAS RD
Mailing Address - Street 2:227
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63141-6800
Mailing Address - Country:US
Mailing Address - Phone:314-569-2208
Mailing Address - Fax:314-569-2319
Practice Address - Street 1:443 N NEW BALLAS RD
Practice Address - Street 2:227
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-6800
Practice Address - Country:US
Practice Address - Phone:314-569-2208
Practice Address - Fax:314-569-2319
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050175051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice