MEDICARE: JENNIFER BRITTANY FEINGOLD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	09572	IA
2	122300000X	Dentist	09572	IA

General Provider Information

NPI Number	:	1356835896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER BRITTANY FEINGOLD DDS

Provider Business Mailing Address
First Line	:	2761 OAKDALE BLVD STE 4
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-9754
Country	:	US
Telephone Number	:	193-626-5437
Fax Number	:

Provider Business Practice Location Address
First Line	:	2761 OAKDALE BLVD STE 4
Second Line	:
City	:	CORALVILLE
State	:	IA
Zip	:	52241-9754
Country	:	US
Telephone Number	:	319-626-5437
Fax Number	:	319-626-2301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/19/2018
Last Update Date	:	12/14/2021

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